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Stroke coordinator-led intervention shows less favorable mRS outcomes in patients aged 80 years and olderTrial Shows Stroke Coordination Program Impacts Outcomes by Age

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Key Takeaway
Note that age modified the intervention effect on mRS, with older patients showing fewer favorable outcomes.

This randomized trial enrolled 301 participants with mild stroke symptoms across 4 Norwegian hospitals. The study compared a multidimensional, stroke coordinator-led, community-based intervention involving monthly meetings and structured risk assessments against standard care. The primary outcome was the modified Rankin Scale (mRS) at 18 months.

In participants aged 80 years and older, a favorable outcome was less likely with the intervention compared to control (23.4% vs 57.0%, p = 0.004). For younger participants, the intervention showed an improvement in Trail Making Test B by -32.2 s (95% CI -58.0 to -6.4, p = 0.015). A significant age-intervention interaction was observed for Trail Making Test B (p = 0.019), while no frailty-intervention interaction was found.

Safety data, including adverse events and discontinuations, were not reported. The study was single-blinded. The findings suggest that age modified the intervention effect on mRS, while frailty did not. Clinicians should note that the intervention did not provide a universal functional benefit for the general population.

How this fits prior evidence

How this fits prior evidence: This study addresses a gap in understanding how specific demographics, particularly older patients, respond to coordinator-led community interventions. While prior coverage has highlighted the benefits of blood flow restriction training for lower-limb function, respiratory muscle training for respiratory function, and BCI technology for cognitive function and activities of daily living, this trial specifically highlights how age modifies the effectiveness of coordinator-led programs in stroke recovery.

Researchers conducted a randomized trial involving 301 people with mild stroke symptoms across four Norwegian hospitals. The study compared a specialized, coordinator-led program involving monthly meetings and personalized goals against standard care. The study followed participants for 18 months to measure physical function, quality of life, and cognitive ability.

The results showed that the intervention had different effects depending on the age of the patient. For younger participants, the program led to a measurable improvement in cognitive speed on the Trail Making Test B. However, for patients aged 80 and older, the intervention group was actually less likely to achieve a favorable outcome compared to those receiving standard care.

While the program did not show a general benefit for everyone, it did show a specific link between age and how well the treatment worked. No link was found between the level of frailty and the success of the program. Because this was a single-blinded study, the results should be viewed as specific to these groups rather than a universal rule for all stroke survivors.

What this means for you:
The stroke program improved cognitive speed in younger patients but did not show benefits for those over age 80.

Common questions

Who does this stroke program help the most?

The study found that the program specifically helped younger participants improve their scores on the Trail Making Test B. This test measures cognitive speed. However, the program did not show a general benefit for the entire population, and results varied significantly based on the age of the patient.

Is the program effective for older stroke patients?

For patients aged 80 and older, the study found that a favorable outcome was less likely with the intervention compared to standard care. The results showed a significant interaction between age and the intervention, meaning the program's effectiveness changed based on how old the patient was.

Does the patient's frailty level affect the results?

The study looked at whether frailty affected the success of the intervention. The researchers found no frailty-intervention interaction. This means that a patient's level of frailty did not change how the program worked for them in this specific trial.

Study Details

Study typeRct
Sample sizen = 301
EvidenceLevel 2
Follow-up18.0 mo
PublishedOct 2026
View Original 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.
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