Trauma and sexual assault may impede stroke recovery: study

Research highlights:

• Exposure to different types of traumatic events and stress over the lifespan appears to reduce the likelihood of optimal recovery after stroke.
• An examination of the health records of U.S. stroke survivors found that sexual assault was consistently associated with poorer physical function and poorer cognitive recovery one year after stroke.

DALLAS, February 1, 2024 — Stressors and traumatic events experienced throughout one’s life can negatively impact the rest of one’s life stroke Recovery; Specifically, stroke survivors exposed to sexual assault at any point in their lives have worse physical and cognitive function one year after their stroke, according to a preliminary study to be presented at the American Stroke Association meeting. It is said to be declining. 2024 International Stroke Conference. The conference will be held in Phoenix from February 7th to 9th and will be the world’s first conference for researchers and clinicians dedicated to the science of stroke and brain health.

“When caring for patients after a stroke, it is important to know what has happened in their life,” said E. Allison, lead author of the study and professor of nursing and psychological sciences. Dr. Holman said. Irvine, California. “Screening for lifelong stress and trauma is important when caring for patients who have had a stroke, as those experiences often have far-reaching effects and affect how well the person does over time. Because it may be possible to predict what will happen.”

Researchers looked at data from the STRONG (Stroke, Stress, Rehabilitation, Genetics) study and identified specific types of stressors that may contribute to adverse physical function and cognitive outcomes one year after stroke. I investigated. In the STRONG study, stroke survivors were evaluated four times per year. Assessments included a lifetime stress and trauma exposure survey completed approximately 90 days after stroke. Participants reported lifetime exposure to 31 different types of stress and traumatic events, such as witnessing a loved one injured or killed. sexual assault; divorce; childhood emotional and physical abuse. And poverty. Additionally, the participant’s physical function and cognitive abilities were assessed one year after the stroke. Researchers evaluated the relationship between lifetime stress and trauma exposure and functional and cognitive outcomes in 763 stroke survivors with a mean age of 63 years.

The analysis revealed the following:

• Sexual assault is the trauma most strongly associated with a moderate decline in the ability to perform activities of daily living and a decline in modified Rankin Scale (representing a person’s functional ability) and Telephone Montreal Cognitive Assessment scores one year after stroke. It was a special event. We controlled for age, gender, race, and National Institutes of Health Stroke Scale score (a measure of stroke severity) 3 months after stroke.
• Other adverse experiences – Witnessing a family member get injured or killed. I’m going through a divorce. and/or being physically abused in childhood were also independently associated with a moderate decline in the ability to perform activities of daily living in the year after stroke.
• These associations remained even when early acute stress levels after stroke were considered in the analysis.
• In contrast, caring for a seriously ill loved one was associated with improved scores on the telephone Montreal Cognitive Assessment. Holman noted that people who care for others are more actively engaged in daily life, which may keep their minds more alert.
• Women were significantly more likely to report having been sexually assaulted or having a loved one who was seriously ill.

Holman emphasized that medical professionals should be aware that sexual assault and other traumatic events that occur throughout a person’s life can have a lasting impact on physical health. Understanding that these past life experiences can shape a patient’s subsequent response to stroke may facilitate more compassionate communication.

“Bad things happen to people, so the goal is to intervene immediately after a stroke to prevent the worst effects. We can use this information to allocate resources in a targeted way and help improve post-stroke outcomes.” We should be able to provide better support to people.’ I have recovered from my stroke,” she said. “Health care professionals can use psychological first aid strategies to support patients’ basic needs, help them cope, and refer them to resources such as support groups and community agencies. For some, simply acknowledging the experience can be liberating in itself.”

“This study raises our awareness of how important it is to manage stressors and increase physical and mental resilience,” said the American Heart Association’s Epidemiology and Cardiovascular Association. said Randy Foraker, Ph.D., MS, FAHA, vice chair of Stroke Nursing Prevention. Scientific Committee Member, Professor of Medicine, Institute of Informatics, Data Science, and Biostatistics, and Director of the Center for Population Health Informatics, Washington University School of Medicine, St. Louis, Missouri. “Some of the ways we strengthen our resilience and health are by engaging in mindful meditation, social engagement, and physical activity. As clinicians, researchers, and caregivers, we encourage stroke survivors to We need to make sure we give people the best chance of living longer and healthier lives.” Dr. Foraker was not involved in the study.

Research details and background:

• The study involved 763 stroke survivors (mean age 63 years, 41.3% women, 60.9% white adults).
• The STRONG study was conducted at 28 stroke centers across the United States from 2016 to 2021.
• The current study results build on the STRONG study, led by Holman and colleague Stephen Kramer, MD, and previously published in the American Heart Association Stroke Journal.September 2023), it was also suggested that exposure to cumulative traumatic stress impairs recovery from stroke.

The main limitations of the study were that patients with severe stroke and non-English speaking patients were excluded, so it is unclear whether the findings apply to these patients. Further research is needed to investigate the potential mechanisms linking these traumatic events to poor outcomes after stroke. Holman suggests that it is important to examine both psychological and physiological processes that may explain this result.

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

Research statements and conclusions presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect the policy or position of the association. The Association makes no representations or warranties regarding its accuracy or reliability. Abstracts presented at the Society’s scientific conferences are not peer-reviewed, but are hand-picked by an independent review committee and considered based on their potential to increase the diversity of scientific issues and views discussed at the conference. The findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.