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Aisha Ahmad Ogdi et al, 2020;4(3):555–559.

International Journal of Medicine in Developing Countries

The lifestyle of the elderly with stroke: a review

Aisha Ahmad Ogdi1*, Feddah Mohammed Hakami1, Dalal Ali Mohammed Mulaysi1, Khetam Hamod Moafa1, Shatha Ibrahim Matabi1, Rawan Mohammed Yahya Sawadi1

Correspondence to: Aisha Ahmad Ogdi

*Intern, Jazan University, Jazan, Saudi Arabia.

Email: aisha.ogdi [at] hotmail.com

Full list of author information is available at the end of the article.

Received: 28 December 2019 | Accepted: 08 January 2020


ABSTRACT

Stroke is considered as the most common disease that led to death among older individuals in many countries today around the world. Risk factors of stroke have been grown annually, which led to health problems that affect the quality of life. Hence, modification of these risk factors became very urgent for the prevention of stroke through different strategies that might have an effective and proactive impact on stroke. In this study, we used an online searching process to obtain scientific articles related to our subject. The searching process involved searching through scientific websites, such as Google Scholar and PubMed. We obtained 15 articles related to the current subject; of them, eight were excluded as they were duplicate articles and may not focus on the current subject, so only seven articles were included. The study concludes that an active lifestyle could lead to an extreme reduction of stroke risks, through different modifications, such as regular physical activity, quitting smoking, weight loss, reducing alcohol consumption, healthy nutrition, in addition to a healthy diet. Effective advances and proactive education of the public are very important and urgent for alleviating and preventing the burden of stroke.


Keywords:

Stroke risk factors, healthy lifestyle, neurological diseases, prevention of stroke, modification of lifestyle.


Introduction

The major type of neurological diseases around the whole world is the cerebrovascular diseases that might include a type of stroke as ischemic strokes, cerebrovascular abnormalities, and hemorrhagia [1]. It was found that stroke is the most known neurological disease that led to numerous death cases, every year [2], such as damaging patients’ vision, perception system, and their cognitive abilities around the world [3]. Its prevalence became a major challenge [3] and was reported among the older adults by the rate of 46–73 per 1,000 people [4], which increased annually due to aging [5]. There are numerous risk factors of stroke, such as falling of patients [6], reduction in patients’ motions or their physical activities [7], social activity reduction [8], and problems of psychological health, in addition to diabetes, hyperlipidemia, smoking, obesity, and hypertension, so it is urgent to prevent and decrease these risk factors by modifying patients’ lifestyle; therefore, it is necessary for patients to learn about the conditions of the lifestyle condition [9]. It was previously reported that changing lifestyles (self-care and the physical condition, such as practicing exercise continuously) would be expected to alleviate chronic diseases and enhance the quality of life among elderly people [10]. Reducing smoking habit and keeping normal weight also promote the quality of life [11]. This might be attributed to the lifestyle which could cover the behavior and habits of life personally. Lifestyle included nutrition, physical activity, quality of sleep, and smoking attitude, which had an impact on people’s health [12]. A healthy lifestyle had a useful effect [13] as it could completely prevent stroke [14]. Hence, developing a healthy community is very important, through achieving health factors, such as encouraging people to undergo healthy habits and providing them with healthy social and physical environments [15]. This spots the lights on paying attention to the adults with stroke. Therefore, this review aimed to identify the lifestyle condition of the elderly with stroke as well as identify those health behaviors that can improve overall health and reduce the risk of stroke.


Materials and Methods

An online searching process was used to obtain scientific articles related to our current subject. The searching process involved searching through scientific websites, such as Google Scholar and PubMed, using several keywords such as stroke risk factors, healthy lifestyle, neurological diseases, and prevention of stroke. We obtained 15 articles (AQ) related to the current subject; of them, eight were excluded (AQ) as they were duplicate articles not focusing on the current subject, so only seven articles (AQ) were included and they were published between 2005 and 2018.

Stroke risks and prevention

To decrease and prevent stroke, the risk factors should be lowered through some effective modification in the lifestyle. This lifestyle modification might include reducing high blood pressure, smoking cutoff, physical activity practicing, maintenance of normal weight, and a healthy diet [16,17]. Any change in lifestyle risk factors might have an obvious effect on the risk. Improving and enhancing healthy behaviors willingly reduce the risk of stroke [18]. We have shown and explained some of the stroke risks and its prevention as follows:

Hypertension or high blood pressure

High blood pressure was shown to affect half of the people around the world and might cause a stroke with an increase in blood pressure parameters. Hypertension that considered as the most modifiable risk factor for stroke was found to be increased with age and reached up to 90% with people of 80 years [19]. A major link was found between blood pressure and stroke in both men and women of all ages. By increasing the age, blood pressure would increase the risk of stroke with 1.7 times in males and 1.9 times in females [20]. Therefore, the treatment should be very urgent and more effective, especially for people with 80 years and more. Such type of therapy, such as antihypertensive therapy with hypertension cases, might reduce the risk of stroke by 30% and decrease mortality by 21% [21]. Finally, modification of the lifestyle in both medications and/or health attitude was reported to be the best approach for achieving effective prevention and reduction of stroke risk for hypertensive people.

Salt reduction

It had a significant effect on reducing blood pressure. Midgley et al. [22] found a decrease in blood pressure that was associated with a reduction in daily sodium intake of 100 mmol for people who were older than 44 years of age. In addition, a decreasing salty diet has been recommended to be a pharmacological treatment for enhancing blood pressure control. Patients who were receiving antihypertensive medication, salt restriction, and limitation provided additional benefits for controlling blood pressure. Erwteman et al. [23] found that an additional 3 mmHg decrease in diastolic blood pressure could be achieved through salt restriction among patients taking diuretics and β-blockers. Similarly, it was reported that a low-salt diet provides an additional 4 mmHg decrease in systolic blood pressure. Salt restriction showed a large benefit in hypertensive patients receiving angiotensin-converting enzyme inhibitors. MacGregor et al. [24] reported that patients receiving captopril had a further decrease in blood pressure when salt intake was moderately reduced. Hence, we can summarize these results as follows: salt restriction led to the reduction of high blood pressure and consequently causes an effective reduction of stroke risks.

Physical activity

It could reduce the risk of stroke in elderly people [25]; practicing five times per week would decrease stroke risk by 25%. The relationship between physical activity and stroke risk has been shown in a study [26], which reported that elderly persons who are highly active had low possibilities for stroke risk than those who had a little activity. This differentiation between the rates of activity might be attributed to high physical activity: decreasing the plasma fibrinogen, reducing the agreeability of platelets, lowering of blood pressure, and weight loss [27].

Diet

A bit change in food style would cause a tremendous reduction of stroke risk, so healthy food showed a beneficial effect on the weight and reduction of blood pressure and cholesterol, and consequently prevent stroke risk. The best diet for stroke management and prevention is a plant diet that mostly included vegetables with a bit amount of meat. This type of diet had a large benefit and a good impact on cardiovascular health and could prevent stroke risks [28]. Consumption of fruits and vegetables in great amounts led to a tremendous reduction of stroke risk with 6% per day [28]. The prevalence of stroke in the United States was related to obesity [29], as overweight was considered as one of the most ten risks of stroke. Approximately one of the five stroke cases caused by overweight. An increasing weight of person, till classified under obesity, might raise stroke risks by 64%; this might be attributed to an increase in weight accompanied with an increase in cardiovascular diseases, high blood pressure, high cholesterol level, and type II diabetes; and all of these possess a strong risk of stroke [29].

Smoking

It is one of the most common risks of stroke and considered as the major reason behind illness in the United States [30], as smoking reduces endogenous fibrinolysis and raises the activity of thrombocyte [30]. Different authors reported that cigarette smoking was contributing to an increase in the rate of stroke risk up to 50% and increases the stroke death rate by 14% [31].

Cholesterol and fats

Cholesterol belongs to saturated fat that reported to increase the risk of coronary heart diseases and stroke [32]. Cholesterol is present in the blood in the form of lipoproteins [low-density lipoprotein (LDL) and high-density lipoprotein (HDL)]; an increase in LDL level would increase stroke risks. In contrast, omega-3 polyunsaturated fatty acids derived from oily fish, such as salmon, and vegetable oil, such as soybean, had an effective impact on the reduction of stroke risks [33]. Decreasing blood cholesterol is very urgent and is highly dependent on individuals’ habits rather than medication [34].

Psychosocial behaviors

Psychosocial behaviors of individuals were found to be associated with biological factors that affect most of the disease risks. More studies proved that the stress of jobs and depression are associated with coronary heart disease and stroke [35]. Different attitudes such as physically inactive and the increase in smoking were found to be related to depression that mainly increases the risk of stroke in both the genders [36]. Therefore, it is important to focus and spot the light on the impacts of psychosocial stress, depression, in addition to social interaction through appropriate studies.

Influenza vaccination

It is considered as a major strategy for preventing stroke risks; more epidemiological and trial evidence stated that influenza vaccination has the ability to decrease the risk of stroke [36]. For elderly people, influenza was considered as a common illness that causes death and morbidity and also a source of infection among the community that prolongs circulating virus. Hence, it was recommended that influenza vaccination must be applied to elderly people.

Lifestyle global modification

It was shown that lifestyle modification globally had an obvious impact on the reduction of stroke risk factors than treatment of each one of the risk factors individually. This was proved through a study which was conducted on a group of patients who maintained lifestyle modification, such as quitting smoking and practice exercise regularly for 30 minutes per day, eating healthy foods, and decrease the consumption of alcohol; all of these had a significant effect on the reduction of stroke by 80% [37]. In this regard, it is very important, especially for elder people, to identify the health behaviors and modifications of their lifestyle and to decrease and prevent stroke risks.

Using medications was one of the major strategies for the prevention of stroke risks. In many randomized trials, hypertension was reported as the most common risk factor of stroke, whereas after treatment of dyslipidemia, using statins, the risk of stroke reduced. In another case, using anticoagulation in case of atrial fibrillation and application of carotid endarterectomy in symptomatic high-grade carotid stenosis prevents stroke disorders, whereas there is no significant impact on the usage of aspirin, statins, or vitamins that are not recommended for healthy people. Although a strong effect was indicated on stroke remediation by maintaining lifestyle modifications, such as normal body weight and physical activity, another literature stated that lifestyle modification is also based on medication [38].


Conclusion

Active lifestyle could lead to an extreme reduction of stroke risks, through different modifications, such as regular physical activity, quitting smoking, weight loss, reducing alcohol consumption, healthy nutrition, in addition to a healthy diet. Appropriate ingredients of food could maintain a proper weight that has a good impact on stroke, as reported through the Mediterranean diet. Withdrawal of tobacco and alcohol also aids in reducing the risks of stroke, whereas the supplement of vitamin and fatty acid food had a little impact on stroke risk reduction. Effective advances and proactive education of the public are very important and urgent for alleviating and preventing the burden of stroke.


List of Abbreviation

LDL Low-density lipoprotein

Conflict of interest

The authors declare that there is no conflict of interest regarding the publication of this article.


Funding

None.


Consent for publication

Not applicable.


Ethical approval

Not applicable.


Author details

Aisha Ahmad Ogdi1, Feddah Mohammed Hakami1, Dalal Ali Mohammed Mulaysi1, Khetam Hamod Moafa1, Shatha Ibrahim Matabi1, Rawan Mohammed Yahya Sawadi1

  1. Intern, Jazan University, Jazan, Saudi Arabia

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How to Cite this Article
Pubmed Style

Ogdi AA, Hakami FM, Mulaysi DAM, Moafa KH, Matabi SI, Sawadi RMY. The lifestyle of the elderly with stroke: a review. IJMDC. 2020; 4(3): 555-559. doi:10.24911/IJMDC.51-1577571984


Web Style

Ogdi AA, Hakami FM, Mulaysi DAM, Moafa KH, Matabi SI, Sawadi RMY. The lifestyle of the elderly with stroke: a review. http://www.ijmdc.com/?mno=79798 [Access: March 29, 2020]. doi:10.24911/IJMDC.51-1577571984


AMA (American Medical Association) Style

Ogdi AA, Hakami FM, Mulaysi DAM, Moafa KH, Matabi SI, Sawadi RMY. The lifestyle of the elderly with stroke: a review. IJMDC. 2020; 4(3): 555-559. doi:10.24911/IJMDC.51-1577571984



Vancouver/ICMJE Style

Ogdi AA, Hakami FM, Mulaysi DAM, Moafa KH, Matabi SI, Sawadi RMY. The lifestyle of the elderly with stroke: a review. IJMDC. (2020), [cited March 29, 2020]; 4(3): 555-559. doi:10.24911/IJMDC.51-1577571984



Harvard Style

Ogdi, A. A., Hakami, . F. M., Mulaysi, . D. A. M., Moafa, . K. H., Matabi, . S. I. & Sawadi, . R. M. Y. (2020) The lifestyle of the elderly with stroke: a review. IJMDC, 4 (3), 555-559. doi:10.24911/IJMDC.51-1577571984



Turabian Style

Ogdi, Aisha Ahmad, Feddah Mohammed Hakami, Dalal Ali Mohammed Mulaysi, Khetam Hamod Moafa, Shatha Ibrahim Matabi, and Rawan Mohammed Yahya Sawadi. 2020. The lifestyle of the elderly with stroke: a review. International Journal of Medicine in Developing Countries, 4 (3), 555-559. doi:10.24911/IJMDC.51-1577571984



Chicago Style

Ogdi, Aisha Ahmad, Feddah Mohammed Hakami, Dalal Ali Mohammed Mulaysi, Khetam Hamod Moafa, Shatha Ibrahim Matabi, and Rawan Mohammed Yahya Sawadi. "The lifestyle of the elderly with stroke: a review." International Journal of Medicine in Developing Countries 4 (2020), 555-559. doi:10.24911/IJMDC.51-1577571984



MLA (The Modern Language Association) Style

Ogdi, Aisha Ahmad, Feddah Mohammed Hakami, Dalal Ali Mohammed Mulaysi, Khetam Hamod Moafa, Shatha Ibrahim Matabi, and Rawan Mohammed Yahya Sawadi. "The lifestyle of the elderly with stroke: a review." International Journal of Medicine in Developing Countries 4.3 (2020), 555-559. Print. doi:10.24911/IJMDC.51-1577571984



APA (American Psychological Association) Style

Ogdi, A. A., Hakami, . F. M., Mulaysi, . D. A. M., Moafa, . K. H., Matabi, . S. I. & Sawadi, . R. M. Y. (2020) The lifestyle of the elderly with stroke: a review. International Journal of Medicine in Developing Countries, 4 (3), 555-559. doi:10.24911/IJMDC.51-1577571984