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Long-term effects of stroke
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
1987 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Stroke, which has an increasing incidence with age, causes an irreversible brain damage which may lead to impairment, disability and decreased life satisfaction or death.

Risk factors for death, recurrent stroke and myocardial infarction, were analyzed in 409 stroke patients treated at the Stroke Unit, Department of Medicine, Umeå University Hospital, between Jan. 1, 1978 and Dec. 31, 1982. The causes of death were related with the time of survival. In fully co-operable (n=62) 4-6 year stroke survivors, the occurrence of motor and perceptual impairments, of self-care (ADL) disability and of self-reported decreased life satisfaction due to stroke was determined.

The probability of survival was 77% three months after stroke, 69% after one year, and 37% after five years. Multivariate statistical analysis indicated that impairment of consciousness was the most important risk factor for death followed by age, previous cardiac failure, diabetes mellitus, intracerebral hemorrhage and male sex. During the first week, cerebrovascular disease (90%) was the most dominant primary cause of death, from the second to the fourth week pulmonary embolism (30%), bronchopneumonia during the second and third months and cardiac disease (37%) later than three months after stroke. The risk of recurrence was 14% during the first year after stroke and the accumulated risk of stroke recurrence after 5 years was 37% after stroke. The estimated probability of myocardial infarction was 7% at one year and 19% at 5 years. High age and a history of cardiac failure increased the risk of recurrent stroke. The risk of myocardial infarction was associated with high age, angina pectoris and diabetes mellitus. The highest risk of epilepsy was found between 6 and 12 months after stroke. Motor impairment prevailed in 36% of the long-term survivors, perceptual impairments in up to 57% and decreased ADL-capacity in 32%. As regards ecological perception, perceptual function variables were distinctly grouped into low and high level perception which together with motor function explained 71% of the variance of self-care ADL. While levels of global and of domain specific variables of life satisfaction appeared stable in clinically healthy reference populations aged 60 and 80 years, the stroke had produced a decrease in one or more aspects of life satisfaction for 61% of the long-term survivors. Although significantly associated with motor impairments and ADL disability, these changes could not only be attributed to physical problems.

Place, publisher, year, edition, pages
Umeå: Umeå universitet , 1987. , 48 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 201
Keyword [en]
stroke, cerebrovascular disease, prognosis, recurrent stroke, myocardial infarction, epilepsy, life satisfaction, motor function, self-care ability, perception, causes of death
National Category
Family Medicine Nursing Cardiac and Cardiovascular Systems
URN: urn:nbn:se:umu:diva-100559ISBN: 91-7174-312-XOAI: diva2:793360
Public defence
1987-10-09, Föreläsningssal D, Tandläkarhögskolan, 9 tr, Regionsjukhuset i Umeå, Umeå universitet, Umeå, 09:00

S. 1-48: sammanfattning, s. 49-114: 5 uppsatser

Available from: 2015-03-11 Created: 2015-03-04 Last updated: 2015-04-10Bibliographically approved
List of papers
1. Life satisfaction in long-term survivors after stroke
Open this publication in new window or tab >>Life satisfaction in long-term survivors after stroke
1988 (English)In: Scandinavian Journal of Rehabilitation Medicine, ISSN 0036-5505, Vol. 20, no 1, 17-24 p.Article in journal (Refereed) Published
Abstract [en]

Different aspects of the quality of life before and after stroke were registered for 62 communicable, representative long-term (4-6 years) survivors, who reported the global and domain specific life satisfaction that they experienced (7 items, 6 graded-ordinal scales). Reference subjects were 60 healthy individuals in two age cohorts (60-61 years, n = 34; 79-81 years, n = 26) none of whom had been hospitalized during the last seven years prior to the investigation. The main finding is that, after the stroke, at least one aspect of the quality of life had decreased for 61% of them; this concerned global, sexual and leisure satisfaction mainly. Moreover, persisting motor impairment and ADL-disability had a negative effect on several aspects of life satisfaction. As nearly 30% of the non-impaired and the non-disabled interviewees reported decreased global life satisfaction, these changes indicate that they do not cope psychosocially with the stroke as such nor with its sequelae. In contrast, the levels of life satisfaction were similar for the 60-61 and 79-81 year-old interviewees, clinically healthy respondents, indicating stability in the quality of life that they experienced from late middle age into senectitude. For the patients, social integration estimated normatively did not covariate significantly with post-stroke satisfaction derived from social relationships.

National Category
Occupational Therapy
urn:nbn:se:umu:diva-81609 (URN)3413451 (PubMedID)
Available from: 2013-10-18 Created: 2013-10-18 Last updated: 2015-04-10Bibliographically approved

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