Early Strokes Have Long-Lasting Effects

New research finds that one-third of individuals who survive a stroke before age 50 are either unable to live independently or require help with daily activities 10 years after the stroke occurred.

A group of researchers from the Radboud University Nijmegen Medical Center in the Netherlands assessed the function of 722 people who had suffered their first stroke between the ages of 18 and 50. After an average follow-up time of 9 years, about one-third of them had at least moderate disability, and needed assistance for some activities.
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Many were also unable to conduct routine tasks on their own, such as caring for themselves, doing household chores, or tending to their finances, according to the study authors, who note that about 10 percent of strokes occur in 18-to-50-year-old individuals.

Upon closer investigation, the researchers found the rate of poor functional outcome and the ability to live self-sufficiently varied by type of stroke. Among those who had suffered a transient ischemic attack, for example, 16.8 percent had functional disability, and 10.8 percent had “poor skills for independence.”

Meanwhile, 36.5 percent of those suffering an ischemic stroke—caused by a blood clot in the brain—had functional disability, with 14.6 percent unable to live independently. After a hemorrhagic stroke, caused by a brain bleed, 49.3 percent of stroke victims had functional disability, and 18.2 percent didn’t have the skills needed to live independently.

Patients fared worse if they experienced another stroke during the follow-up period, according to investigators. Among the 91 patients experiencing an additional stroke, 54.9 percent were at least moderately disabled, versus 28.7 percent of those that didn’t experience a recurrent stroke. The authors note that 33.3 percent of those suffering multiple strokes were dependent on others for assistance with daily living, compared to 11.5 percent of those without a recurrent stroke.

“Most doctors view young stroke patients as a group with great recovery opportunities,” according to Frank-Erik de Leeuw, PhD, associate professor of neurology at the Radboud University Nijmegen Medical Center, and senior study author, noting that this study is the first to show these “almost life-long effects of stroke” on performance.

“This is important to communicate right from the start to patients and families,” says de Leeuw, who adds that the authors are investigating factors most responsible for poor functional outcome.

“We don’t know if it’s cognition, depression, problems in their families, or relationships, or other factors,” he says. “But once we do, we can develop more effective interventions.”

—Mark McGraw

Reference

de Leeuw F, Synhaeve N, et al. Poor Long-Term Functional Outcome After Stroke Among Adults Aged 18 to 50 Years: Follow-Up of Transient Ischemic Attack and Stroke Patients and Unelucidated Risk Factor Evaluation (FUTURE) Study. Stroke. 2014.