March 27, 2008 -- A stroke can have a major impact on every aspect of a person's life, including his or her job. New research shows that only about half of stroke survivors are able to return to work, and continuing disability and depression are major causes.
Though people often associate strokes with old age -- in other words, retirees -- about 20% of strokes actually occur in people of working age, the study authors say. Because of the general aging of the population and an increase in stroke survival rates, the condition can have a noticeable impact on the workforce.
The weakness, speech, and movement problems that often occur after a stroke can lead to a lengthy disability period for many patients. Often stroke survivors also develop depression and other psychiatric problems. All of these factors can contribute to the decision not to return to work.
To assess the impact of stroke on employment, researchers in Australia and New Zealand looked at 210 previously working patients (average age 55) who had had a first stroke between 2002 and 2003. Researchers assessed patients soon after their stroke, then again at one and six months afterward.
Fifty-three percent of patients were able to return to full-time work within a few months of their stroke, the researchers reported in the journal Stroke. "It can be quite heartening to families and clinicians that more than half of stroke patients go back to work," study researcher Nick Glozier, MD, PhD, associate principal director of The George Institute for International Health in Sydney, Australia, says in a news release. "But physicians should continually assess patients' mood after stroke, because it's an important predictor of whether patients will go back to work."
Depression did have a significant independent impact on work status after a stroke. Forty-five percent of patients who didn't return to work at six months were depressed, compared with 33% of those who did go back to work. Only 30% of those patients with depression following stroke reported receiving treatment for this.
"If family members pick up on someone being depressed after a stroke, ask the physician to assess them and intervene if necessary," Glozier advises. "Post-stroke depression can be successfully treated, and treatment can help the patients, their families, and society."
Other important determinants in whether patients could get back to work were the severity of the stroke and the patients' ability to care for themselves independently. Seventy-one percent of those who were working six months after a stroke were rated "independent" on a scale of self-care abilities called the Barthel Index, compared with only 32% of those who didn't go back to work. Glozier says people who are functioning well after a stroke should consider vocational rehabilitation, which can help them make the transition back into the workforce.
The authors say the next step in research is to look at ways to prevent and manage stroke-related depression to help improve patients' quality of life.