More research required to find innovative solutions to restore lives affected by stroke, health groups say
JULY 23, 2014, OTTAWA – In the next two decades, the number of Canadians living with long-term disability from stroke will increase by up to 80 per cent due to the aging population and population growth, according to a study published today in the medical journal Stroke.
The report provides an updated estimate of the scope of long-term stroke disability and includes, for the first time, children under the age of 12 and people living in institutions. Previous estimates were out-of-date and incomplete, making it difficult for agencies to plan for services and treatment. Accurate data is also required to monitor improvements in treatment and prevention.
According to the study – prepared for the Ontario Stroke Network (OSN), the Heart and Stroke Foundation Canadian Partnership for Stroke Recovery (HSFCPSR) and the Heart and Stroke Foundation (HSF) – at least 405,000 Canadians were living with long-term stroke disability in 2013, a number that’s 30 per cent higher than the most commonly used estimate.
But the big story is the projected growth in stroke disability rates in all parts of the country. “The number of people living with long-term stroke disability will rise to between 654,000 and 726,000 by 2038,” said lead author Dr. Hans Krueger, a Vancouver-based health economist and adjunct professor at the University of British Columbia. The largest projected increase is in the Prairie Provinces (Alberta, Saskatchewan and Manitoba), where there will be as many as 132,000 people living with stroke disability by 2038, an increase of as much as 128 per cent from 2013 levels.
“These findings highlight the critical need for research to find and test innovative solutions to improve recovery for the hundreds of thousands of Canadians living with stroke disability,” said Dr. Dale Corbett, Scientific Director and CEO of the HSFCPSR.
“The good news is that we are creating more survivors, thanks to tremendous progress in stroke care,” said David Sculthorpe, CEO, HSF. “But we need to do even more to keep up with the growing threat of stroke including raising awareness of the signs of stroke and improving prevention and care.”
OSN Executive Director Chris O’Callaghan said the study further underlines the need to address the availability of outpatient and community rehabilitation. “With increasing numbers of Ontarians affected by stroke, rehabilitation and recovery services need to be available across the province to ensure people regain their lives” she said. “Ideally, stroke rehabilitation services would be provided by a multi-disciplinary health care team and available to all ages, in a variety of settings over the long-term, as recovery can continue well beyond six months.”
O’Callaghan said the OSN is working with the Ministry of Health and Long-Term Care, Health Quality Ontario, Local Health Integration Networks and Ontario’s 11 Regional Stroke Networks to improve access to post stroke rehabilitation services and data availability within hospitals, outpatients and the community.
Eighty-three per cent of people survive a stroke and the effects range from mild to severe disability. Recovery can take months or even years and many people never fully recover. About 36 per cent of stroke survivors are left with significant disabilities after five years and more than 40 per cent require help with the activities of daily living (bathing, dressing, etc.).
Still, the study under-estimates the complete scope of stroke recovery in Canada because it only includes people who have been diagnosed with physical or cognitive impairments lasting at least six months. It does not include individuals with a mild stroke or TIA (transient ischemic attack), nor does it capture people living with dementia commonly caused by undiagnosed stroke.
STROKE DISABILITY BY THE NUMBERS
- The prevalence of stroke survivors living with disability will as much as double in some regions of Canada by 2038.
- The largest increase is projected for the Prairie Provinces (AB, SK, MB), where it is estimated there will be between 116,000 and 132,000 stroke survivors living with disability in 2038. This represents an expected increase from 2013 that ranges between 100% and 128%.
- Stroke disability rates are expected to increase between 65% and 71% in the Atlantic provinces (PEI, NS, NB, NL), between 49% and 54% in Quebec, between 68% and 74% in Ontario, and between 87% and 111% in British Columbia.
- In 2013, there were 191,000 men living with stroke disability and 214,000 women.
- Of Canadians living with stroke disability in 2013, 354,500 lived in the community, 49,900 lived in homes-for-the-aged and 400 were young children.
- Despite stable prevalence rates, the number of people living with stroke disability increased by 95,000 between 2000 and 2013 due to population growth and aging.
- Between 2000 and 2013, the number of stroke survivors living with disability increased by almost 29 per cent (7,000 individuals) in the Atlantic provinces, by 41 per cent (26,000 individuals) in Quebec, by 32 per cent (41,000 individuals) in Ontario, by 16 per cent (8,000 individuals) in the Prairie provinces, and by 31 per cent (13,000 individuals) in BC.
Study co-authors include Dr. Dale Corbett of the University of Ottawa, Dr. Mark Bayley of Toronto Rehabilitation Institute, Dr. Ruth Hall of the Institute for Clinical Evaluative Sciences, Christina O’Callaghan of the Ontario Stroke Network and Jacqueline Koot of H. Krueger and Associates Inc.
ABOUT THE ONTARIO STROKE NETWORK
The Ontario Stroke Network provides provincial leadership and planning for the continuum of stroke care in Ontario—from health promotion and stroke prevention to acute care, recovery, rehabilitation and reintegration. Visit the OSN’s website at www.ontariostrokenetwork.ca.
ABOUT THE HSF CANADIAN PARTNERSHIP FOR STROKE RECOVERY
The HSF Canadian Partnership for Stroke Recovery is a joint initiative of the Heart and Stroke Foundation and Canada’s leading stroke research centres. Headquartered at the University of Ottawa, the Partnership is restoring lives through research. Learn more at www.canadianstroke.ca
ABOUT THE HEART AND STROKE FOUNDATION
The Heart and Stroke Foundation’s mission is to prevent disease, save lives and promote recovery. A volunteer-based health charity, we strive to tangibly improve the health of every Canadian family, every day. Healthy lives free of heart disease and stroke. Together we will make it happen. heartandstroke.ca
Ontario Stroke Network
HSF Canadian Partnership for Stroke Recovery
Heart and Stroke Foundation of Canada