Impact of age and frailty on the effect of a multimodal individualized long-term intervention after stroke: the last-long trial
In brief
Stroke coordinator support yielded fewer favorable outcomes in patients aged 80+
In this randomized trial, 23% of participants aged 80 or older receiving monthly stroke-coordinator support had a favorable functional outcome at 18 months, compared with 57% receiving standard care. The overall trial found no functional benefit; younger participants improved on one cognitive test, and frailty did not alter response. The age-related finding comes from a subgroup analysis and needs cautious interpretation.
- Journal
- Journal of rehabilitation medicine (Q1)
- Published
- 26 October 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Håkon Ihle-Hansen, Bente Thommessen, Sara Rise Langlo, Elin Bergh, Anne Hokstad, Stian Lydersen, et al.
- PMID
- 42929098
- DOI
- 10.2340/jrm.v58.46250
Why clinicians should know about it
- Picked for Rehabilitation (top studies of the week, 1 November 2026): Age‑frailty analysis of long‑term stroke rehab trial
Abstract
BACKGROUND: The LAST-long randomized trial tested a multidimensional, stroke coordinator-led, community-based intervention and found no overall functional benefit. Because most participants had mild stroke symptoms, whether older or frailer subgroups benefited was examined. METHODS: In this single-blinded RCT at 4 Norwegian hospitals (2019-2022), 301 participants were randomized 1:1 to monthly stroke-coordinator meetings for 18 months (structured risk assessment and individualized goals) or to standard care. PRIMARY OUTCOME: modified Rankin Scale (mRS) at 18 months. SECONDARY OUTCOMES: mortality, cognition, ADLs, physical function, fatigue, and quality of life. Older age: ≥ 80 years; frailty: Frailty Index ≥ 0.2. Linear and logistic regression tested age- and frailty-intervention interactions. RESULTS: mRS data were available for 268 participants (136 intervention, 132 control). Mean age 71.1 (SD 12.4); 66 (24.6%) ≥ 80; 89 (33.2%) frail. Age modified the intervention effect on mRS: among participants ≥ 80, favourable outcome was less likely with intervention vs control (23.4% vs 57.0%, p = 0.004). For secondary outcomes, the intervention improved Trail Making Test B in younger participants (-32.2 s, 95% CI -58.0 to -6.4, p = 0.015) with a significant age-intervention interaction (p = 0.019). No frailty-intervention interaction was found. CONCLUSIONS: Age - but not frailty - modified response to the intervention, indicating differential effects in older participants. CLINICAL TRIALS: gov identifier: NCT03859063.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.