Stroke Care: What’s Age Got to Do With It?

Stroke patients respond similarly to post stroke care no matter how old they are

(RxWiki News) Levels of stroke care can often be dependent on a patient’s age. When it comes to aggressive post-stroke therapy, however, older patients may have just as much to gain as younger ones.

Some studies have found that older stroke patients are less likely to receive certain types of post-stroke treatment, such as antihypertensive therapy or documented measures of blood cholesterol.

New research suggests that after-stroke care, like blood pressure management, should be applied across all age groups.

"Check if your age is determining your post-stroke therapy."

Neale Chumbler, PhD, head of the department of health policy and management in the College of Public Health at the University of Georgia in Athens, and a team of researchers examined data on 3,196 patients treated for ischemic strokes (strokes caused by blood clots). The patients were from 127 Veterans Affairs medical centers.

Dr. Chumbler studied outpatient response to care quality and if the response changed based on age. He looked at depression symptoms, responses to blood thinning medications and average blood pressure, blood sugar and cholesterol levels over a period of six months after patients were released from the hospital following a stroke.

Regardless of age, patients had little difference in health quality or response to care, suggesting that age should not be the driving factor in after-stroke therapy.

“Stroke management should be guided by the best clinical evidence and guidelines irrespective of age,” wrote the authors.

Dr. Chumbler said, "Anyone who has a stroke should have these risk factors monitored when they are sent home and when they come back for follow-up appointments. Traditionally, preventative care has not been as aggressive for older patients. This research shows it is just as important for people in their 80s as it is for those in their 50s."

For example, older post-stroke patients may not be screened for depression, a risk factor associated with stroke, according to Dr. Chumbler. Treatment for depression was higher among patients younger than 55.

“Post-stroke depression is very common; 35 to 40 percent of all individuals are at risk for developing severe clinical depression after stroke, so it is very important to monitor prevention strategies for stroke survivors," he said.

Even though older patients benefit as much, if not more, from stroke prevention treatments, previous research suggests older patients are less likely to receive interventions than younger patients. Dr. Chumbler's findings suggest they have just as much to gain.

Sarah Samaan, MD, cardiologist and physician partner at the Baylor Heart Hospital in Plano, Texas, told dailyRX News, “Often after a stroke, a patient may seem dependent and perhaps not mentally sharp, so some physicians may not be as inclined to be as aggressive as they might after a heart attack. However, there is usually some degree of improvement for up to two years after the stroke. Some people will recover nearly completely. A second stroke can be even more devastating than the first, so it's important we do everything we can to reduce the risk for subsequent strokes and, at the same time, help to protect the heart.”

Dr. Samaan added, “It is not surprising that depression is common after a stroke, but the issue may not always be addressed or acknowledged. Depressed people are less likely to care for themselves, and more apt to make poor lifestyle choices that further raise their risk for heart disease and stroke.”

The study was published in the April issue of the Journal of Rehabilitation Research and Development.

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Review Date: 
May 21, 2013