Stroke research and the importance of occupational therapy support
Exploring the latest stroke research
January 29th was Stroke Prevention Day, an awareness day to educate individuals on the stroke risk factors, with each year focusing on a different risk, and offering solutions to reduce said factors.
At Krysalis, we have seen first-hand the effect stroke has.
Our neurological occupational therapists are an expert team that understand the challenges that stroke can cause. And while we work to provide a solution for life after stroke, new research into the early warning signs of stroke can help prevent this neurological event.
The Rotterdam Study
This was a major population study that followed more than 14,700 people for over 26 years.
The study found that those who later experiences a stroke had already shown a steeper decline in cognitive skills and daily functioning compared to those who remained stroke free. These changes were detectable up to ten years before their first stroke. [1]
A 2025 international update of this study across twenty-three countries confirmed that this trend was accurate. The scientists studying long-term brain health have found that subtle changes in thinking skills, memory, and everyday functioning may slowly appear overtime, long before it is connected to stroke risk.
Orientation, executive function, and processing speed are also said to decline in the years pre-stroke. [2]
Patients who had a stroke have steeper declines in cognition and daily functioning up to 10 years before their first-ever stroke, compared with stroke free individuals. 
The Rotterdam Study
Understanding the risk
Researchers have also found that some groups are at greater risk, including people with genes linked to Alzheimer's disease. These neurological factors mean that brain health and stroke risk are more linked that previously understood.
To monitor these long-term changes, researchers used well-known tests such as the Mini-Mental State Examination (MMSE) that focuses on memory and cognition, the Purdue Pegboard Test, and the Stroop Test, both focusing on dexterity and processing speed individually.
All these showed differences years before stroke in those who later experienced one. Averages from these studies show that a first stroke occurred at around age 80, yet the signs were quietly pesent long before.
However, not all research finds the same pattern.
A 2024 global collaboration of fourteen international cohorts found that some people presented little evidence of decline before their stroke. So, while this research suggests that early change in cognition and function varies from person to person, influenced by genetics, lifestyle, and health conditions. [3]
Occupational therapy is about understanding the individual's view of their world which now, due to the consequences of their brain injury or disability, may have changed.
Krysalis Founder and CEO, Jo Throp
Recognising stroke symptoms
Stroke remains the second leading cause of death globally, and spotting the symptoms quickly is crucial in preventing permanent damage. For some individuals, a smaller, temporary episode - a transient ischaemic attack (TIA) - happens first, but the symptoms can still be similar.
Stroke symptoms can include:
- Sudden, severe headache
- Loss of consciousness
- Paralysis on one side
- Problems with balance
- Sudden blurred vision
- Difficulty swallowing
Post-stroke fatigue (PSF) is one of the most widely reported symptoms after a stroke or TIA.
A global analysis found that 47% of stroke survivors experience PSF, and the number does not significantly reduce over time, meaning fatigue often remains a long-term challenge.
Alongside these physical symptoms, new research is showing that subtle cognitive changes may also act as early red flags.
A 2026 study using AI to review routine GP notes found that "whispers" of cognitive decline, including subtle forgetfulness or slowed thinking, often appear long before formal diagnosis, and may be linked to increased cerebrovascular risk. [4]
Now I have a deeper insight into how my body and mind have been affected by my stroke. No one ever fully explained it to me in hospital, but I now understand my stroke and ways to manage my symptoms.
Stroke beneficiary
The role of neurological occupational therapy
At Krysalis, we know that every stroke is different. It can depend on which part of the brain is affected, and each individual experiences their symptoms differently.
A 2024 clinical trial discovered that early occupational therapy intervention during the hospital-to-home transition after stroke not only improves independence but also improved overall quality of life. [5]
This is why our neurological occupational therapists work hard to support individuals living with the effects of stroke.
We can provide education on symptoms, introduce strategies and tools, and support individuals to return to work or return to the roles and routines that they need or want to do.
While the research underscores how valuable it can be to recognise early signs, we know that many strokes happen without warning, and that the right support at the right time can be vital.
Recently on talking heads...
References
[1] Heshmatollah, A. et al. (2021). "Long-term trajectories of decline in cognition and daily functioning before and after stroke". Journal of Neurology, Neurosurgery and Psychiatry.
[2] https://link.springer.com/article/10.1007/s00415-025-13511-4
[3] Lo J.W. et al. (2024). "Trajectory of Cognitive Decline Before and After Stroke in 14 Population Cohorts". JAMA Network Open.
[4] Estiri H. et al. (2026). "Autonomous AI agents for detecting early cognitive concerns". npj Digital Medicine.
[5] https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0308800
Last updated: 2nd February 2026