Life after Heart Attack and Stroke

By Jane Farrell

Increasing numbers of people are surviving heart attacks and stroke, but they may suffer a sharper, decline in physical abilities than previously thought, according to a new study led by the University of Michigan.

Many heart attack and stroke survivors required long-term assistance for activities such as dressing, bathing, grocery shopping and managing finances. Additionally, stroke survived appeared to be at higher risk of depression and mental decline.

The study was published in Circulation: Cardiovascular Quality and Outcomes.

“More people are surviving heart attack and stroke than ever before but the long-term consequences for survivors may be much greater than we thought,” says lead author Deborah Levine, M.D., M.P.H. assistant professor of internal medicine in the U-M Medical School.

“We found that over time, survivors had increasing difficulty performing everyday tasks like walking, bathing, shopping and managing money and that these struggles got progressively worse every year following a heart attack or stroke.”

Over ten years, the study found, survivors of heart attack suffered approximately 1.5 to 3.5 new functional limitations (problems with performing daily tasks). Survivors of stroke suffered approximately 3.5 to 4.5 limitations.

For the study, the researchers analyzed Medicare records from 1998-2010 and from the Health and Retirement study, a national survey of older Americans funded by the National Institute on Aging and based at the U-M Institute for Social Research (ISR). The records analyzed were of 391 heart attack survivors and 370 stroke survivors.

The number of heart attack and stroke survivors is expected to increase by 25 percent over the next two decades because of treatment advances and an aging population. Simultaneously, the number of caregivers for older adults is expected to decline.

Senior author Theodore Iwashyna, M.D., Ph.D. associate professor of internal medicine at the U-M Medical School, said the study’s of increased difficulties after heart attack and stroke called for careful monitoring of such patients after discharge.

“Our findings suggest that heart attack and stroke survivors should be screened and monitored for functional disability long after discharge from the hospital because patients may need additional help with activities of daily living over the years after heart attack and stroke.”

Additionally, the investigators found that patients’ new limitations contributed to significant increases in depressive symptoms among survivors. The risk of developing severe depressive symptoms were 20% greater for every new functional limitation suffered after heart attack and 34% greater for every new functional limitation suffered after stroke.