Long-term outcomes: survivors’ experiences up to 15 years after stroke

*new* Dr. Siobhan Crichton and Dr. Benjamin Bray  talk about this study on a Soundcloud podcast by BMJ Talk Medicine.

Researchers at King’s College London use South London Stroke Register data to understand the long term consequences of stroke. Recently they did an analysis of outcomes for Register participants who lived up to 15 years after their stroke. The outcomes they looked at were survival, disability, activity, cognitive impairment, quality of life, depression and anxiety.

The researchers found that one in five people live at least 15 years after their stroke, and that many of these people live with disability and psychological problems. For example, one in 10 of the people who lived for 15 years after their stroke had lived with moderate to severe disability since their stroke.

The study emphasises that, as more people survive stroke, “research and health services will need to increasingly focus on preventing and managing the long-term consequences of stroke”.

The study was designed and carried  out by researchers and clinicians at King’s College London and the NIHR Biomedical Research Centre, Guy’s & St. Thomas’ NHS Foundation Trust and King’s College London. The article described is published as: Crichton, S. L., B. D. Bray, C. McKevitt, A. G. Rudd and C. D. A. Wolfe (2016). “Patient outcomes up to 15 years after stroke: survival, disability, quality of life, cognition and mental health.” Journal of Neurology, Neurosurgery & Psychiatry (may require subscription to access).

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Results from the South London Ethnicity and Stroke Study

Stroke incidence (the number of people who have a stroke) is higher in people with black ethnic backgrounds but the reasons for this are not well understood. The South London Ethnicity and Stroke Study (SLESS) has tried to better understand why people of black ethnicity are at higher risk of stroke by exploring patterns in the different types of stroke and in the underlying risk factors. The journal article on the final results from the study are available in the BMC Medicine journal here.

The study recruited 2400 patients (black Caribbean, black African and white ethnic groups) from an area of South London and analysed information on the subtype of stroke that they had had (e.g. small vessel stroke or cardioembolic stroke) and the risk factors that they had had before the stroke (e.g. high blood pressure). They found that black patients and white patients do not have the same chance of having each subtype of stroke.

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A novel peer support intervention to promote resilience after stroke

Researchers from King’s College London in collaboration with a number of other institutions recently completed a project on the role of resilience in adjustment after stroke. (article opens in a new window/tab). Resilience can be defined as being able to ‘bounce back’ or thrive in the face of adversity, such as coping with a long-term condition. Resilience is recognised as an important part of well-being and mental health, but little is known about its role in helping stroke survivors to adjust.

In the project, the researchers looked at the existing evidence on adjustment after stroke and peer support. They talked with stroke survivors, carers and professionals about what ‘resilience’ meant to them. They then developed a new intervention to promote resilience after stroke and did a ‘feasibility test’ (a study to see if the intervention can be put into practice) with a small number (11) of older stroke survivors.

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A psychologically-informed walking intervention for stroke survivors

Researchers at King’s College London have designed a study to find out whether it is feasible to deliver a newly developed walking intervention for stroke survivors and to evaluate it using a randomised, controlled design.

The intervention has been adapted from a similar walking programme designed for sedentary (inactive) adults, based on the results of two previous studies with stroke survivors. It involves one-to-one sessions with a “walking coach,” helping people feel motivated to walk more and to fit walking into their daily lives.

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