Stroke affects more than just the physical

"After a stroke, people who have only mild disability can often have 'hidden' problems that can really affect their quality of life," said study author Irene L. Katzan, MD, MS, of the Cleveland Clinic in Ohio and a member of the American Academy of Neurology. "And for people with more disability, what bothers them the most? Problems with sleep? Depression? Fatigue? Not many studies have asked people how they feel about these problems, and we doctors have often focused just on physical disability or whether they have another stroke."

The study involved 1,195 people who had an ischemic stroke, or a stroke where blood flow to part of the brain is blocked. They were asked questions about their physical functioning, fatigue, anxiety, sleep problems, thinking skills such as planning and organizing, how much their pain affects other aspects of their life and their satisfaction with their current social roles and activities.

Participants took the questionnaires an average of 100 days after their stroke, and about a quarter of the participants needed help from a family member to fill out the questionnaires. Researchers also measured their level of disability.

The people with stroke had scores that were considerably worse than those in the general population in every area except sleep and depression. Not surprisingly, the area where the people with stroke were most affected was physical functioning, where 63 percent had scores considered meaningfully worse than those of the general population, with an average score of 59, where a score of 50 is considered the population average.

On the question about whether they were satisfied with their social roles and activities, 58 percent of people with stroke had scores meaningfully worse than those of the general population.

"People may benefit from social support programs and previous studies have shown a benefit from efforts to improve the social participation of people with stroke, especially exercise programs," said Katzan.

The thinking skills of people with stroke in executive function, or planning and organizing, were also affected, with 46 percent having scores that were meaningfully worse than the population average.

"The social participation and executive functioning skills are areas that have not received a lot of attention in stroke rehabilitation," Katzan said. "We need to better understand how these areas affect people's well-being and determine strategies to help optimize their functioning."

Limitations of the study include that the questionnaires did not ask about other problems that can occur after stroke, such as communication issues. Also, the study participants had milder strokes on average than people with stroke overall and the average age of participants was 62, which is lower than the average age of 69 for people with stroke overall.