A third of people who survive a stroke before age 50 are unable to live independently or need assistance with daily activities 10 years after their stroke, according to a study.
About 10% of strokes occur in people ages 18 to 50, according to a news release from the American Heart Association/American Stroke Association.
Even if patients seem relatively well recovered with respect to motor function, there may still be immense invisible damage that leads to loss of independence, Frank-Erik de Leeuw, PhD, senior author of the study and associate professor of neurology at the Radboud University Nijmegen Medical Center in the Netherlands, said in the news release.
As published Feb. 27 on the website of the journal Stroke, researchers assessed the function of 722 people who had a first stroke when they were ages 18 to 50. After an average follow-up of nine years, about a third had at least moderate disability, requiring assistance for some activities. Many also were unable to conduct routine tasks independently, such as caring for themselves, doing household chores or looking after their finances.
Upon closer investigation, researchers found the rate of poor functional outcome and the ability to live independently varied by type of stroke:
After a transient ischemic attack, 16.8% had functional disability and 10.8% had poor skills for independence.
After an ischemic stroke, 36.5% had functional disability and 14.6% were unable to live independently.
After a hemorrhagic stroke, 49.3% had functional disability and 18.2% did not have the skills for independent living.
Most doctors view young stroke patients as a group with great recovery opportunities, de Leeuw said. But our study is the first to show these almost lifelong effects of stroke on performance. This is important to communicate right from the start to patients and families.
Patients fared worse if they experienced another stroke during the follow-up period. Of the 91 patients who experienced a recurrent stroke, 54.9% were at least moderately disabled, compared with 28.7% of those without a recurrent stroke; and 33.3% were dependent on others in activities of daily living, compared with 11.5% of those without a recurrent stroke.
The researchers are investigating factors most responsible for poor functional outcomes.
We dont know if its cognition, depression, problems in their families or relationships or other factors, but once we do, we can develop more effective interventions, de Leeuw said.
Study abstract: https://stroke.ahajournals.org/content/early/2014/02/27/STROKEAHA.113.004411.abstract