Stroke Survival At 80: Is It Possible?

Stroke is a leading cause of death and disability worldwide, and older people are particularly vulnerable. In fact, strokes are the fourth leading cause of death in the US, and the second globally. In the US, about 795,000 people have strokes each year, and 137,000 of those people die.

Age is a significant factor in long-term survival after a stroke. People aged 85 and older have the highest death rate: their risk of dying is 13 times higher than that of people aged 65 to 74. The risk of dying is three times higher for people aged 75 to 84 compared to those aged 65 to 74.

However, age is not the only factor influencing stroke recovery. The type of stroke

The importance of timely treatment

Strokes are the fifth leading cause of death in the United States and a leading cause of long-term disability. They are a medical emergency and receiving treatment as soon as possible is critical to improving outcomes. Indeed, treatment within 3 hours of symptom onset is critical in helping to improve a patient's outcome.

The first 24 hours after a stroke are crucial for starting rehabilitation and minimising long-term effects. During this time, the patient is admitted to an emergency department to stabilise their condition and determine the type of stroke. If it is an ischemic stroke caused by a blood clot, clot-busting medication can be administered to reduce long-term effects if the patient is treated in time.

The first few weeks after a stroke are spent in the hospital, where the stroke care team evaluates the effects of the stroke to determine the rehabilitation plan. The patient will then undergo physical and occupational therapy up to six times a day to evaluate the damage and jump-start the recovery process.

Within the first three months after a stroke, most patients will enter and complete an inpatient rehabilitation program or make significant progress in their outpatient therapy sessions. This period is when patients will see the most improvement, and it is also when they may experience spontaneous recovery, where a lost skill or ability suddenly returns.

Even after six months, when improvements become much slower, it is still crucial to continue following up with the care team. This includes physiatrists, neurologists, physical and occupational therapists, and rehabilitation psychologists. While improvement may take longer for some patients, there is still hope for small advances.

Age-related conditions and their impact on recovery

Age is a critical factor in determining the long-term functional recovery of patients who have suffered a stroke. Research shows that patients aged 70 and above exhibit functional decline between 6 and 30 months after the stroke, while patients below 70 years of age show functional improvement until 6 months after the stroke.

Impact of Age-Related Conditions on Recovery

The ability to recover from a stroke depends on factors other than age. Seniors aged 80 and above can benefit from being surrounded by support systems that help them heal. Family members can act as advocates for their loved ones and ensure they are not discharged from the hospital too soon, which can lead to poorer outcomes. Additionally, seniors with pre-existing health conditions like heart disease or brain trauma may be at risk of second strokes that can cause further damage.

Age-Related Conditions Affecting Recovery

• Cognitive issues: Older adults may experience cognitive problems, including issues with awareness, thinking, attention, memory, learning, and judgment.
• Physical issues: Paralysis, weakness, or numbness on one side of the body, as well as difficulty with chewing or swallowing, are common physical issues that can affect recovery.
• Emotional issues: Depression and anxiety are common emotional issues that can impact an older adult's ability to recover from a stroke.
• Other health issues: Seniors aged 80 and above may have other health problems, such as heart disease, that can increase the risk of second strokes and further complicate the recovery process.

The role of social support in the healing process

Social support is vital for holistic stroke management and can have a positive impact on a patient's recovery. The quality and quantity of social support are both important, with high levels of social support influencing participation in social and leisure activities, as well as returning to work after a stroke. Social support interventions should be included in rehabilitation plans to aid reintegration into the community.

The quantity of social support has a significant impact on participation in activities. This is especially true in the acute phase of recovery, when individuals require large amounts of support to cope with the challenges of their disability. A large number of people in a support network and a strong social network can lead to positive outcomes in participation, even up to 10 years after a stroke.

The quality of social support is generally provided over the long term, both before and after a stroke. Emotional support, such as caring, acceptance and listening, and instrumental support, such as practical help, are important aspects of social support. Emotional support from family and friends can improve an individual's functioning and, therefore, their participation in activities. Instrumental support from spouses or family members can aid with activities of daily living, such as providing transportation.

Social support interventions should focus on incorporating group activities and include family members and caregivers. Outdoor activities with support structures can also aid social support and community participation.

In addition to social support, other factors that influence recovery from a stroke include the location of the stroke in the brain, the extent of brain damage, the survivor's motivation, the quantity and quality of rehabilitation, and the survivor's health before the stroke.

The significance of addressing other health issues

The presence of other health issues can significantly impact an 80-year-old's ability to recover from a stroke. Seniors with pre-existing health conditions, such as heart disease, are at a higher risk of experiencing a second stroke, which can cause further damage and hinder the recovery process. Additionally, older adults with existing brain trauma may struggle to regain their full abilities.

To optimize the chances of recovery, it is crucial to address these health issues alongside the stroke treatment plan. This comprehensive approach ensures that the individual's body is physically strong enough to embark on the healing process. By managing underlying health conditions, the risk of subsequent strokes can be mitigated, improving the overall prognosis.

The recovery journey for seniors over 80 is not solely dependent on their age. With advancements in medical testing and treatments, individuals in this age group are achieving better recovery outcomes than ever before. The level of damage to the brain, the timing of medical intervention, and the support system in place are all critical factors that influence the recovery process.

To summarize, addressing other health issues is of utmost significance when it comes to stroke recovery in 80-year-olds. By doing so, we can reduce the likelihood of subsequent strokes, enhance the individual's overall health, and improve their chances of a successful recovery.

The benefits of inpatient rehabilitation and its impact on recovery outcomes

Inpatient rehabilitation facilities (IRFs) provide 24-hour hospital-level care to stroke survivors requiring intense daily supervision by a rehabilitation physician. Inpatient rehabilitation can be located independently or as part of a large hospital complex. Typically, patients remain in the facility for two to three weeks, participating in a coordinated rehabilitation program that includes at least three hours per day of physical, occupational, and speech therapy for at least five days a week.

Benefits of Inpatient Rehabilitation

• Intensive and coordinated care: Inpatient rehabilitation offers a structured and comprehensive approach to recovery, providing a range of therapies and specialist support under one roof.
• 24-hour medical supervision: Stroke survivors receive round-the-clock medical care, which is crucial for managing post-stroke complications and ensuring patient safety.
• Specialised equipment: IRFs have access to specialised equipment that may not be available at home or in outpatient settings, enhancing the effectiveness of rehabilitation.
• Multidisciplinary approach: Inpatient rehabilitation involves a team of professionals, including physicians, nurses, physical and occupational therapists, speech therapists, and social workers. This multidisciplinary approach addresses the diverse needs of stroke survivors.

Impact on Recovery Outcomes

• Improved functional independence: Inpatient rehabilitation focuses on restoring functional abilities, such as activities of daily living, mobility, and communication. Studies have shown that inpatient rehabilitation significantly improves functional independence and quality of life for stroke survivors.
• Reduced risk of complications: The intensive care and monitoring in IRFs can help prevent and manage post-stroke complications, such as urinary incontinence, infections, and aphasia, which have been linked to unfavourable prognoses.
• Enhanced social support: Inpatient rehabilitation provides an opportunity for social interaction and support, which is associated with better recovery outcomes. Social workers and support groups within IRFs can also assist patients and their families in adjusting to life after a stroke.
• Addressing malnutrition: Malnutrition is common after a stroke and is associated with poorer outcomes. IRFs can provide nutritional support and ensure patients receive adequate nourishment to aid their recovery.
• Improved long-term outcomes: Inpatient rehabilitation can lead to better long-term outcomes, including reduced risk of recurrent strokes and improved quality of life.

Frequently asked questions