title: Patient outcomes up to 15 years after stroke: survival, disability, quality of life, cognition and mental health.
abstract: The global epidemiological shift of disease burden towards long-term conditions means understanding long-term outcomes of cardiovascular disease is increasingly important. More people are surviving stroke to experience its long-term consequences, but outcomes in people living more >10 years after stroke have not been described in detail.
  
  
  
  Data were collected for the population-based South London Stroke Register, with participants followed up annually until death. Outcomes were survival, disability, activity, cognitive impairment, quality of life, depression and anxiety.
  
  
  
  Of 2625 people having first-ever stroke, 262 (21%) survived to 15 years. By 15 years, 61% (95% CI 55% to 67%) of the survivors were male, with a median age of stroke onset of 58 years (IQR 48-66). 87% of the 15-year survivors were living at home and 33.8% (26.2% to 42.4%) had mild disability, 14.3% (9.2% to 21.4%) moderate disability and 15.0% (9.9% to 22.3%) severe disability. The prevalence of disability increased with time but 1 in 10 of the 15-year survivors had lived with moderate-severe disability since their stroke. At 15 years, the prevalence of cognitive impairment was 30.0% (19.5% to 43.1%), depression 39.1% (30.9% to 47.9%) and anxiety 34.9% (27.0% to 43.8%), and survivors reported greater loss of physical than mental quality of life.
  
  
  
  One in five people live at least 15 years after a stroke and poor functional, cognitive and psychological outcomes affect a substantial proportion of these long-term survivors. As the global population of individuals with cardiovascular long-term conditions grows, research and health services will need to increasingly focus on preventing and managing the long-term consequences of stroke.
authors.affiliation: Division of Health and Social Care Research, King's College London, London, UK NIHR Biomedical Research Centre, Guy's & St. Thomas' NHS Foundation Trust and King's College London, London, UK.
authors.forename: Siobhan L
authors.initials: SL
authors.lastname: Crichton
authors.affiliation: Farr Institute of Health Informatics, University College London, London, UK.
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Bray
authors.affiliation: Division of Health and Social Care Research, King's College London, London, UK NIHR Biomedical Research Centre, Guy's & St. Thomas' NHS Foundation Trust and King's College London, London, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: McKevitt
authors.affiliation: Division of Health and Social Care Research, King's College London, London, UK NIHR Biomedical Research Centre, Guy's & St. Thomas' NHS Foundation Trust and King's College London, London, UK.
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Rudd
authors.affiliation: Division of Health and Social Care Research, King's College London, London, UK NIHR Biomedical Research Centre, Guy's & St. Thomas' NHS Foundation Trust and King's College London, London, UK National Institute of Health Research Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South London, London, UK.
authors.forename: Charles D A
authors.initials: CD
authors.lastname: Wolfe
mesh_terms: D000203:Activities of Daily Living / Q000145:classification; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis / Q000401:mortality / Q000523:psychology; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000401:mortality* / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012042:Registries; D020521:Stroke / Q000175:diagnosis* / Q000401:mortality* / Q000523:psychology; D016019:Survival Analysis; D016896:Treatment Outcome