By Abiodun E. Akinwuntan
With improving care due to more knowledge, early detection, medication, and better care protocols, especially in the acute phase, survival of a stroke incidence is increasing. Such care has seen stroke dropping from the third leading cause of death to the fifth in the United States. While current efforts at increasing chances of surviving a stroke occurrence are highly commendable, such efforts need to progress to ensuring the highest quality of life for the survivors. This is even more important with the increase in stroke occurrence and survival among young persons. It is very encouraging and refreshing to see that discussions on addressing the challenges that young stroke survivors face is increasing in some developed countries around the world. This editorial highlights the salient facts presented in four recent different reports on initiatives that address the plight of young stroke survivors in Australia. Nick Rushworth highlights what can be perceived as one of the benefits of aligning with a bigger body that advocates for a diverse population of brain injured persons to bring the challenges facing young stroke survivors to the forefront of disability-themed discussions. Aligning with Brain Injury Australia led to the choice of “YoungStroke” as the theme for the 2016 edition of the national Brain Injury awareness week. After being provided with compelling statistics on the impact of stroke on young people, Brain Injury Australia advocated for more services, support, and research into young stroke, especially since the incidence of stroke is increasing among young people despite the decreasing trend for older individuals. The article by Natasha Lannin and colleagues suggested that the occurrence of stroke among young people in Australia is higher in individuals of Aboriginal and Torres Strait Island origin. The plan, according to the article, is to continue to monitor the incidence, prevalence, and care of Aboriginal and Torres Strait Island people using the growing Australian Stroke Clinical Registry’s data.
Stroke among young people is particularly worrisome because of its impact on a population. Apart from its significant economic impact, its effect on family and societal life is huge. In many cases, the stroke does not only affect the survivor, it directly affects the entire family including spouses, siblings, children, and parents of the survivors. In light of the fact that many of the factors that cause stroke in young individuals are modifiable, it is important to engage in effective preventive measures and best care practices. Research needs to focus on best ways to control the risk factors of stroke in young individuals. Interventions after stroke onset need to be aimed at maximal reintegration into the society and return pre-stroke vocational routine. Half measure in both prevention and management of stroke is not enough. To ensure best attempts at reducing the incidence and burden of young stroke, survivors, family members, and government must become primary stakeholders in the process. Only extensive interactions and discussions with survivors can help researchers understand what the focus of research in this population should be. The Center for Research Excellence in Stroke Rehabilitation and Brain Recovery at the Florey Institute of Neuroscience and Mental Health in Melbourne, Australia is doing just that. In October 2017, the center, with funding by the National Health and Medical Research Council, facilitated an interactive meeting between 27 researchers and 28 individuals, half of whom were young stroke survivors. This is an initiative in the right direction and one that other centers and institutions dedicated to addressing challenges facing young stroke survivors worldwide need to copy. In the United States, YoungStroke, Inc. is an organization that is working very hard to raise awareness of the challenges with prevention, treatment, and quality of life issues that young stroke survivors face. The organization constantly creates different forums for researchers with survivors to interact while escalating the outcomes of such interactive sessions to the attention of the government and international organizations.
In summary, more attention is needed to effectively address a growing concern: rising incidence of stroke among young individuals and the challenges faced by survivors. Discussions around and awareness of effective prevention methods such as healthy life style and dietary choices, physical activities, moderation of alcohol intake and smoking cessation are required. More research on mproving diagnostic processes, development and adoption of best acute care practices, and identifyinh most effective rehabilitation interventions are also required. For these endeavors to be successful, all hands have to be on deck. Clinicians, researchers, survivors, family members, and governments need to engage in meaningful interactive discussions to set priorities and engage in initiatives that will not only reduce the incidence of young stroke but will also address challenges faced by survivors.
Abiodun E. Akinwuntan, PhD, MPH, MBA
Dean KU School of Health Professions
Professor, Department of Physical Therapy and Rehabilitation Science
Professor, Department of Neurology
Phone: 913-588-0096; Fax: 913-588-5254