3 year stroke survivors: the long term impact of stroke on cognition and factors associated with recovery

Worldwide, stroke is the second commonest cause of death and the most frequent cause of disability in adults, having an enormous physical, psychological and financial impact on patients, families, the health care system, and society. There is evidence that stroke should be considered a long-term condition, with many stroke survivors still experiencing adverse outcomes several years after their stroke. One of the strongest predictors of post stroke outcome are severity and patient age. Stroke severity can be judged clinically, based upon the degree of neurological impairment and the size and location of the infarction. Other important influences on stroke outcome include cardiovascular disease, co-morbid conditions, epidemiologic factors, cognitive impairment and complications of stroke. Severity of stroke is one of the most important factors affecting short and long-term outcome. Existing data on long-term health-related outcomes within the stroke population is limited; has small sample sizes, poor verification of stroke subtypes, poor study design and short-term follow-up (within 12 months). In addition there is a lack of data which provides a fair representation of all ethnic groups in New Zealand who have experienced a stroke. Accurate and representative longitudinal data are needed to determine the impact of stroke, in order to identify key factors that may impact stroke recovery and identify vulnerable groups who are at greater risk for poorer outcomes following stroke. This may provide a greater insight into who is affected most with stroke and why. This study seeks to examine the burden of stroke at three and six-years (n=2180). Identification of predictors that make independent contributions to outcomes post- stroke will inform the development of techniques to manage and/or cope with such deficits, guide remediation and optimize rehabilitation. This study provides a unique opportunity to address current gaps in knowledge in this area and may inform healthcare policy to improve overall outcomes in this population