Loss of function after stroke may be inevitable

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Even people who have recovered well from an ischemic stroke may exhibit functional decline after the first six months and for up to five years, according to the findings of a large study (Stroke. 2009;40:2805-2811).

According to a statement announcing the results, these new data suggest that “in terms of function, stroke could be a considered a chronic condition showing steady decline over time.”

Researchers studied 525 ischemic-stroke survivors, aged 40 years and older (average age 68.6 years) from the stroke-focused Northern Manhattan [New York] study. Depending on which factors were considered, researchers found that the odds of patients' having a full recovery dropped by as much as 9% per year over the five-year follow-up period—even in patients considered functionally recovered six months after stroke and even in the absence of a subsequent stroke, heart attack, or other medical condition that would have an impact on function.

Gender and ethnicity were not significant predictors of functional decline in this study, but insurance status was. Uninsured and Medicaid patients had a significant decline in function over five years, but those covered by Medicare or private insurance did not.

Another recent study of survivors of ischemic stroke found that higher levels of physical activity before a stroke may be associated with functional advantages after the event (J Neurol Neurosurg Psychiatry. 2009;80:1019-1022).

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