Stroke in the younger: Self-reported impact on work situation, cognitive function, physical function and life satisfaction - A national survey

The majority of people affected by stroke are older however one fifth of all persons with stroke are younger than 65 years. In Sweden the mean age at the time of a stroke is 75 years and about 5 % of those who suffer a stroke are 55 years or younger. The aim of this thesis was to describe and analyse the consequences of stroke in the younger population in terms of experiences of the rehabilitation process, return to work, self-reported physical and cognitive function and life satisfaction. Sex differences, as well as gender specific associations regarding factors of importance for return to work, deteriorated physical ability and satisfaction with life as a whole, were also studied. This thesis was based on an in-depth interview study and self reported data collected from a questionnaire answered by 1068 individuals, 18-55 years old with a first ever stroke registered in Riks-Stroke, the Swedish national quality register for stroke care. The questionnaire concerned aspects of current health condition, living and social arrangements, physical and cognitive functions, activities in daily life, relationships, social life, leisure pursuits, self-perception, participation, work and life satisfaction. Most of the questions aimed to investigate differences between the present time and before stroke onset. In-depth interviews with two men and three women aged 37-54, living at home after their stroke generated the hypotheses that younger persons with stroke are frustrated and feel invisible and outside. Rehabilitation for the young was perceived as in adequate due to the fact that the rehabilitation setting does not acknowledge the specific needs that younger persons with stroke have. Prior to the stroke 855 of 1068 (80%) of the participants, had been in paid employment. After the stroke, 65% of the men and 66 % of the women returned to work. Factors of importance for return to work were associated with the self-reported data: the feeling that it was important to work (OR 5.1), not perceiving oneself as a burden to others (OR 3.3), not having a deteriorated ability to run a shorter distance (OR 2.8) and having support for return to work (OR 3.7). Changes in self-reported physical and cognitive functions as compared with pre-stroke condition was explored in 867 (513 men and 354 women) P-ADL independent persons with stroke. Deteriorated physical abilities were reported in 56-79% and deteriorated cognitive abilities in 48- 68% of the participants. Women were significa