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Association between physical activity and mortality among community-dwelling stroke survivors


Joundi, Raed (2021), Association between physical activity and mortality among community-dwelling stroke survivors, Dryad, Dataset,


Objective:  To determine the relationship between physical activity and mortality in community-dwelling stroke survivors.

Methods:  The Canadian Community Health Survey was used to obtain self-reported physical activity (PA) across four survey years and was linked to administrative databases to obtain prior diagnosis of stroke and subsequent all-cause mortality.  PA was measured as metabolic equivalents (METs) per week and meeting minimal PA guidelines was defined as 10 MET-hours/week.  Cox proportional hazard regression models and restricted cubic splines were used to determine the relationship between PA and all-cause mortality in respondents with prior stroke and controls, adjusting for sociodemographic factors, co-morbidities, and functional health status.

Results:  The cohort included 895 respondents with prior stroke and 97805 controls.  Adhering to PA guidelines was associated with lower hazard of death for those with prior stroke (adjusted hazard ratio [aHR] 0.46, 95% CI 0.29-0.73) and controls (aHR 0.69, 95% CI 0.62-0.76). There was a strong dose-response relationship in both groups, with a steep early slope and the vast majority of associated risk reduction occurring between 0 and 20 MET-hours/week.  In the group of stroke respondents, PA was associated with stronger associated risk reduction in those <75 years of age (aHR 0.21, 95% CI 0.10-0.43) compared to those >75 years of age (aHR 0.68, 95% CI 0.42-1.12). 

Conclusions:  PA was associated with lower all-cause mortality in a dose-dependent manner among those with prior stroke, particularly in younger stroke survivors.  Our findings support efforts towards the implementation of PA programs for stroke survivors in the community. 


Canadian Institutes of Health Research, Award: MFE 164702