Risk Factors For Stroke

Some risk factors for stroke — age, gender, family history and race — cannot be changed. Other risk factors — transient ischemic attacks (TIAs), smoking, high blood pressure, diabetes, high cholesterol level, obesity, physical inactivity, alcohol use, irregular heartbeat — can be modified, treated or managed.

• Age
  Increased age is the dominant risk factor for stroke.
• Gender
  Men have a slightly higher risk of getting stroke than women; however, by age 75, stroke is 26% more common in women than in men.
• Family history
  A family history of heart disease or stroke before age 65 increases one's likelihood of stroke.
• Race
  Black Canadians and Asian Canadians have a higher rate of stroke than Caucasian Canadians.
• Previous transient ischemic attack (TIA) or mini-stroke
  A person having a TIA will experience stroke symptoms for a few seconds, minutes, or up to an hour, then the symptoms will pass. A TIA may leave little or no permanent brain damage; however, up to 20% of people who have had one or more TIAs are at risk of having a stroke within a year.
• Smoking
  Cigarette smoking can lead to stroke. Quitting smoking can reduce a person's risk of stroke by 22% after two years, and by 90% after four years.
• High blood pressure
  Left untreated, high blood pressure brings a 40% chance of stroke within 10 years.
• Diabetes
  Adult-onset diabetes (Type 2 diabetes) is also a significant risk factor for high blood pressure and heart disease.
• Elevated blood cholesterol
  Excess cholesterol clogs the arteries, increasing the risk of stroke.
• Excess weight/obesity
  Excess weight can cause a person to develop high blood pressure and diabetes, which are risk factors for stroke. The greater the obesity, the greater the risk of stroke.
• Physical inactivity
  Exercising for 20 minutes, three times a week helps guard against stroke and several risk factors for stroke-high blood pressure, diabetes and obesity.
• Excessive alcohol use
  Heavy drinking (more than two drinks a day) and binge drinking appear to increase the risk of hemorraghic stroke.
• Irregular heartbeat
  Atrial fibrillation occurs when the muscle fibres in the upper chambers (atria) of the heart beat out of rhythm. Atrial fibrillation is a risk factor for ischemic stroke.

Warning signs of stroke

• sudden weaknesses
  
• sudden numbness or tingling in face, arms, legs, especially on one side
• sudden trouble speaking or understanding speech, slurred speech
• sudden loss of vision in one eye, or double vision
• sudden, intense, unusual headache
• dizziness, unsteadiness, sudden fall, especially combined with any of the above signs

Note: Stroke-like symptoms can also signal infection such as meningitis, a drug overdose or a seizure.

Special Situations

Aphasia — speech and language problems
Aphasia is difficulty with speech and language, due to stroke, brain injury or a neurological condition. A person with aphasia may have trouble reading, writing, talking, understanding speech and language. Whether the aphasia is short-term or permanent, the inability to communicate can be a major source of frustration for stroke survivors and caregivers.

Types of aphasia:

• Receptive aphasia
  A person with receptive aphasia cannot understand language, cannot take in (receive) what is being said or communicated.
• Expressive aphasia
  A person with expressive aphasia knows what he wants to say but cannot express it.
• Global aphasia
  With global aphasia, a person can neither understand what is being communicated nor express what he is thinking.

A speech and language therapist can help the stroke survivor improve or regain use of language. The therapist can also provide the caregiver tips and techniques to improve communication.

Dementia

Depression
Mood, behaviour and personality changes can occur as a result of brain damage from stroke; or as result of the survivor's reaction to the effect of the stroke on his body, his mind, his sense of himself and his life circumstances. The mood swings and behavioural changes may lessen as the person recovers. However, up to half of all stroke survivors show signs of depression in the two years immediately following a stroke.

Watch for signs of depression and arrange for professional help from a family doctor, psychologist or psychiatrist.

Loss of awareness/neglect
Nerve damage from stroke can cause a loss of sensation along one side of the body. This loss of feeling, combined with muscle weakness, may cause a person to lose awareness of the impaired side and neglect it.

	Encourage the stroke survivor to become aware of the impaired side.
	Rearrange objects in the home so that they are oriented towards the side that is not impaired.

Use memory aids, such as written notes, index cards and appointment books. Break up tasks into small steps.

Ask a physiotherapist about special stretching exercises to prevent muscle shortening and minimize muscle stiffness and pain.