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Improving the Outcome from Stroke: A Work in Progress

James Kennedy, MB, MRCP(UK)
Clinical Stroke Fellow,
University of Calgary, Calgary, AB.

Alastair M Buchan, MB, FRCP
Professor of Stroke Neurology,
University of Calgary, Calgary, AB.

 

"It is in the nature of stroke to partly take away the use of a man's limbs and to throw him on the parish if he had no children to look to."1

 

While treatments have changed since George Eliot's time, attitudes to the consequences of stroke have not. Stroke, when mild, is viewed by the elderly as a devastating event; when severe it is viewed as being worse than death itself.2

Stroke is the third most common cause of death and the leading cause of disability in most of the developed world.3 It is one of the most common causes for the elderly to be admitted to a chronic care facility, such as a nursing home. Ischemic stroke increases in incidence as people age, rising from 2.1 per 1000 for men aged 55 to 64 to 9.4 per 1000 for men aged 75 to 84.4 Age is also one of the major determinants of outcome from stroke. Older patients are less likely to recover than are younger patients with similar sized infarcts and, following a stroke, are more likely to decline physically than to recover.