A Third of the People Hospitalized for Strokes were Under the Age of 65
May is Stroke Awareness Month
Strokes are one of the major causes of neurological disabilities in older people, and after age 55 the risk for stroke is as high as 1 in 5 for women and 1 in 6 for men (1). If you or a loved one has suffered from a stroke, know that you are not alone and that extensive treatment options are available for stroke patients.
What causes strokes?
A stroke occurs when the blood supply to the brain is interrupted, often caused by a blockage such as a blood clot cutting off one of the blood vessels supplying the brain, or by one of these blood vessels bursting. The brain is dependent on the oxygen carried by blood in order to function, so when an area of the brain does not receive blood for several minutes then this area can suffer from damage.
How common are strokes?
According to the CDC, nearly 800,000 people in the US will suffer from a stroke each year. Of these, around 1 in 4 strokes will happen to someone who has had a previous stroke, and the other 3 of 4 will be new cases (2).
Strokes are often thought of as something that older people suffer from, and it is certainly true that the risk of stoke increases with age. Strokes also have serious consequences for older people, as around half of people over 65 who experience a stroke suffer from reduced mobility as a result. However, strokes can occur at any age – for example, around a third of people hospitalized for strokes in 2009 were aged under 652.
The effects of a stroke
With immediate diagnosis and treatment, the long-term effects of a stroke can be lessened. Diagnosis may happen using a brain scan to identify injured areas
of the brain, and treatment can include giving medication to break up blood clots, or surgery to stop bleeding in damaged portions of the brain (3). After this initial treatment, stoke patients will work with a neurologist and/or a neuropsychologist to see what cognitive effects the stroke has had.
As a stroke can damage different areas of the brain, it is hard to know what the exact effects of a stroke will be. Some common symptoms following a stroke are cognitive problems such as loss of memory, difficulty speaking or writing, problems with concentration, or problems with planning ahead, or movement problems such as paralysis of one side of the body or of certain body parts, or poor balance and problems with co-ordination. Other issues that can occur after a stroke include problems with swallowing, vision, or continence.
Particularly distressing for patients are communication problems that can arise after a stroke. Strokes can damage the areas of the brain involved in the understanding and production of language, which means that patients may not be able to understand what is said to them. They may also not be able to produce speech correctly or to read and write fluently. This can be extremely isolating and scary for the patient, so speech and language therapists can help by offering communication aids like letter charts or finding alternative methods of communication such as gestures (4).
Recovery from stroke
Recovery from strokes, like other brain injuries, is difficult to predict. Sometimes patients will recover almost completely from their injuries, while other patients will be permanently disabled. This makes the recovery process difficult for both patients and their families, as there is no way to know for sure when or to what extent the patient will recover.
People who are recovering from strokes may feel frustrated or disheartened by the difficulties they face in everyday life, particularly if they are used to being independent and taking care of themselves. Some seemingly simple skills that they used to be able to perform by themselves, such as buttoning up a shirt, can become a major challenge and take months or weeks of physical therapy to re-learn.
It is important for families and caregivers to be patient with the sufferer during this time and to empathize with the feelings of hopelessness, anger, or resentment that may arise from not being able to perform tasks as they used to be able to. Patients often suffer from depression or anxiety following their stroke, so caregivers should be on the lookout for signs of these and other psychological or emotional problems (5).
During the recovery process, stroke patients will work with a variety of doctors and therapists depending on their particular needs. Some of the most common treatments that they will receive include rehabilitation exercises like motor skills training or mobility training with physiotherapists. These exercises often involve repetitive tasks like squeezing a ball or sitting and standing from a chair in order to improve the patient's muscle strength, balance, and overall mobility (1).
This kind of rehabilitation work can be physically exhausting for the patient as well as psychologically demanding. The slow progress of recovery can make it difficult for patients to feel like they are improving, which can be compounded by psychological factors such as impairments in long-term planning. For this reason, community support can be invaluable for stroke patients in recovery: having people around who understand the difficulties that they are facing and can offer encouragement, even over the long months or years that recovery may take (7).
Other kinds of rehabilitation work that a patient might undergo after a stroke include psychological evaluation and treatment, occupational or speech therapy, pelvic floor exercises, or eye movement therapy, depending on the specific needs of the patient.
Long term recovery
As people who have had one stroke at a higher risk for a second stroke, it is important for families to be aware of risk factors and take steps to prevent another stroke. Steps to prevent stroke include changing to a diet with a higher proportion of fresh fruits and vegetables, maintaining a healthy weight, taking exercise and being physically active, not smoking, and not drinking too much alcohol (6). These steps will help improve overall health and well-being as well as reducing the chance of future stroke.