Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Thursday, February 1, 2024

Where you live may be associated with more successful stroke recovery

 Duh! If you don't have the economic werewithal to spend hours each days looking for stroke rehab options, of course you're not going to recover as well. All due to the incompetence of your doctor not working towards getting 100% recovery rehab protocols. Blame your doctor, they are completely at fault for not solving stroke to 100 recovery!

Where you live may be associated with more successful stroke recovery

American Stroke Association International Stroke Conference 2024, Abstract Poster HUP3
Research Highlights:
  • Stroke survivors living in areas with high levels of unemployment, low income, low education levels and poor housing quality had twice the risk of poor recovery after a stroke compared to those living in areas with better conditions.
  • The researchers say this study may help promote awareness of how social determinants of health are as important as clinical variables and health information when trying to identify stroke survivors who are at particularly high risk for poor long-term outcomes.

Embargoed until 4 a.m. CT/5 a.m. ET, Thursday, Feb. 1, 2024

DALLAS, Feb. 1, 2024 — Stroke survivors living in areas with poor economic conditions were twice as likely to have a poor recovery compared to survivors living in areas with better conditions, according to a preliminary study to be presented at the American Stroke Association’s International Stroke Conference 2024. The meeting will be held in Phoenix, Feb. 7-9, and is a world premier meeting for researchers and clinicians dedicated to the science of stroke and brain health.

“This research was inspired by the people I work with daily,” said Leah Kleinberg, B.A., a postgraduate clinical research associate in the Falcone Lab in the department of neurology at Yale School of Medicine in New Haven, Connecticut. “Although stroke patients from differing socioeconomic backgrounds often have similar functional status at discharge, outcomes can vary dramatically a year later. As a clinical research associate, I get to interact with them far beyond the completion of their urgent treatment, which sparked my interest in exploring the long-term outcomes for these patients.”

Kleinberg and her colleagues found a significant correlation between functional outcomes after a stroke and the socioeconomic factors noted by census blocks.

“The magnitude of this impact is what was most surprising. We did not expect a large disparity in outcomes, yet we found patients in the most economically disadvantaged areas were twice as likely to have unfavorable outcomes compared to patients in areas with less unemployment, better housing quality and higher income and education levels,” she said.

In this study, researchers used data from Yale’s Longitudinal Study of Acute Brain Injury and  Area Deprivation Index (ADI) rates for the 2020 U.S. Census blocks to compare outcomes among stroke survivors by socioeconomic disadvantage factors. The ADI evaluates a neighborhood on levels of income, education, employment and housing quality and is specific to each zip code. It was developed by the U.S. Health Resources & Services Administration to inform health care delivery and policy for disadvantaged areas.

This analysis found:

  • Among 2,164 people with ischemic (clot-caused) stroke, the one-year unadjusted risk of poor outcomes was 35%, 40% and 46% for patients residing in neighborhoods with low, intermediate and high deprivation, respectively.
  • After considering the inability of the ADI to specifically measure each level of deprivation, researchers determined that those living in intermediate and high deprivation areas had 44% and 107% greater risk, respectively, of unfavorable outcomes, compared to patients living in neighborhoods with low deprivation levels.
  • The patients in the poor outcomes category were unable to look after their own affairs without assistance and required some help in daily activities. In the good outcomes category, patients could live independently, though some might have had residual symptoms or disability.

“We hope this study will help promote awareness of how social determinants of health are as important as clinical variables and health information when trying to identify patients who are particularly high risk for poor long-term outcomes,” she said.

Study details:

  • The Yale Longitudinal Study follows stroke survivors admitted to the Yale Health System, collecting outcome data at 3 months, 6 months and then yearly after hospital discharge. Zip code data was available for 2,164 patients enrolled in the Yale Longitudinal Study between 2018 and 2021. The average age was 69; 48% were women; 7.5% were Black adults and 7.7% were Hispanic adults.
  • Stroke outcomes were determined by trained assessors using the modified Rankin Scale, which measures disability severity after stroke on a scale of 0-6, from no disability (able to carry out all daily living tasks and duties without assistance) to severe disability (bed-ridden, incontinent, requiring constant nursing care and attention).

Study limitations are that the Area Deprivation Index relies on geographic blocks and does not evaluate each household separately. Also, due to the observational nature of the study, the findings can only note associations and cannot determine cause and effect.

When considered separately from other cardiovascular diseases, stroke ranks fifth among all causes of death, behind diseases of the heart, cancer, COVID-19 and unintentional injuries/accidents, according to the American Heart Association’s Heart Disease and Stroke Statistics 2024 Update. The Association also recognizes that considering the role of social determinants of health is essential in improving the cardiovascular health of all Americans.

“Access to quality care, nutritious foods, stable housing or other basic health needs are crucial for people recovering from stroke,” said Elizabeth A. Jackson, M.D., M.P.H., FAHA, immediate past chair of the Association’s Committee on Social Determinants of Health and a professor and director of the Cardiovascular Outcomes and Effectiveness Research Program at the University of Alabama at Birmingham, who was not involved in the research. “Unfortunately, these data are not surprising, rather, they support prior evidence suggesting health disparities are disproportionately experienced in areas where higher degrees of social vulnerability exist.”

Co-authors, disclosures and funding sources are listed in the abstract. 

Statements and conclusions of studies that are presented at the American Heart Association’s scientific meetings are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. Abstracts presented at the Association’s scientific meetings are not peer-reviewed, rather, they are curated by independent review panels and are considered based on the potential to add to the diversity of scientific issues and views discussed at the meeting. The findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.

The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers and the Association’s overall financial information are available here.

Additional Resources:

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About the American Stroke Association

The American Stroke Association is devoted to saving people from stroke — the No. 2 cause of death in the world and a leading cause of serious disability. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat stroke. The Dallas-based association officially launched in 1998 as a division of the American Heart Association. To learn more or to get involved, call 1-888-4STROKE or visit stroke.org. Follow us on Facebook, X.

For Media Inquiries and AHA Expert Perspective:

AHA Communications & Media Relations in Dallas: 214-706-1173; ahacommunications@heart.org

Karen Astle: 214-706-1392, Karen.Astle@heart.org


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