A Stroke Predictor

It turns out there is a surprisingly reliable way to predict a stroke, even years before it happens. If an adult starts to have trouble with what doctors label as ‘executive function’ or maintaining independent ‘activities of daily living,’ that is a powerful predictor of stroke.

What are executive function and activities of daily living?

Having the ability to maintain independent activities of daily living means being able to do the things you need to do to take care of yourself, such as keeping up with personal hygiene, including bathing, shaving and taking care of your hair or makeup.

 Other activities of daily living include getting dressed, getting around your own home and eating.

Executive function means problem solving. So, executive function defines your ability to do things like sewing on a button if it falls off or cleaning up a mess after a spill. In general, executive function has to do with planning out actions and responding to unexpected events that might throw off your regular routine. 

How far ahead of time can a stroke be predicted? 

Recent research studies have shown that a decline in executive function and activities of daily living can be documented as long as 10 years prior to a stroke! 

A research study from Harvard School of Public Health found that adults who experienced worsening activities of daily living were far more likely to have a stroke than adults who did not have a problem maintaining independent activities of daily living. The authors of the study even took the data a step further and compared adults who survived a stroke with adults who died from a stroke.

It turned out that the adults who died from stroke had a worsened level of independence prior to the stroke than the adults who survived the stroke.

Another research study, published in The Journal of Neurological Sciences found that worsening executive function could predict a stroke as far as 10 years down the road.

The study authors write that, “Testing for executive dysfunction may help identify individuals at risk for stroke in time to prevent them.”

Would you notice if you had a problem with executive function? 

Some people might notice their own developing problem with executive function, but many of us might not notice if we were to experience a setback in executive function or activities of daily living. 

Often, a spouse or close relatives, friends or coworkers are the ones who recognize a problem with these skills. It is very difficult to point out to someone that he seems to be having a problem with executive function or activities of daily living. So, that brings up the next point- is there anything can you do about it?

Can you do anything to change the chances of having a stroke?

This is the most important part of the whole idea of predicting a stroke. While it is true that worsening executive function and declining ability to independently carry out activities of daily living have predicted a stroke up to 10 years down the line, that doesn't mean that you can't make some changes to reverse your stroke risk.

A potential reason for this association can be due to the presence of stroke risk factors themselves causing “silent” ischemia to the brain or heart or other physical impairments. In fact, a decline in your capabilities should be a warning sign to start taking care of your health if you haven't been doing so already.

Some proven ways to reverse your stroke risk include getting medical check-ups and following your health care team’s advice to maintain a healthy blood pressure and control diabetes. Maintaining healthy blood levels of fat and cholesterol have been shown to reduce the risk of stroke. Lifestyle changes, such as starting moderate exercise, reducing stress and, most importantly, quitting smoking can dramatically reduce your risk of stroke.

If your loved one is the one experiencing these problems, you need to be the one to take the initiative to inform her doctors so that she can get the best medical treatment possible to reduce her long-term chances of having a stroke and improve her quality of life.

Sources:

Capistrant BD, Wang Q, Liu SY, Glymour MM, Stroke-associated differences in rates of activity of daily living loss emerge years before stroke onset, Journal of the American Geriatric Society, June 2013 

Oveisgharan S, Hachinski V, Executive dysfunction is a strong stroke predictor, Journal of Neurological Science, February 2015

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