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Slow Decline Often Follows Stroke Recovery
Date:6/25/2009

People with less access to health care may deteriorate most, study finds,,

THURSDAY, June 25 (HealthDay News) -- Within five years of a stroke, even people who initially recover often slip into a gradual decline -- especially those with limited access to health care, a new study finds.

Stroke is the third leading cause of death in the United States, and some 795,000 people in the country have a stroke each year, according to the American Heart Association.

"Usually, stroke is seen as an episodic condition that occurs in discrete events," said the study's lead researcher, Dr. Mandip S. Dhamoon, a neurology resident at Columbia University College of Physicians and Surgeons in New York City.

However, "our data suggest that, in terms of function, stroke could be considered a chronic condition showing a steady decline over time, even in the absence of discrete events such as recurrent strokes or heart attacks," he said.

The report is published in the June 25 online edition of Stroke.

For the study, Dhamoon's team collected data on 525 participants from what's known as the Northern Manhattan Study. All had been 40 or older when they had a stroke for the first time.

The researchers rated people's function over time, assessing their ability to carry out 10 activities with and without assistance. They were evaluated every year for five years.

The team found that, "even when patients recover most functional ability in the first months after an ischemic stroke, they gradually become more dependent over the next five years," Dhamoon said. An ischemic stroke is caused by a clot that blocks a blood vessel in the brain.

"The odds of having a full recovery -- living independently or needing very little assistance -- fell as much as 9 percent per year over five years," he said. "At the same time, the odds of patients being rated as severely disabled compared to the first six
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