Stroke survivors who felt constrained from sharing their feelings about their condition with family or friends reported increased loneliness and worse physical and cognitive outcomes one year later, according to preliminary research to be presented at the American Stroke Association’s International Stroke Conference 2026. The study suggests that social constraints may be as significant as stroke severity in predicting long-term disability.
Researchers analyzed data from 763 participants in the STRONG study, a multi-center investigation of stroke recovery conducted at 28 U.S. sites between 2016 and 2021. At three months post-stroke, participants answered questions about whether they felt their primary support person did not want to hear their concerns or if they had to withhold feelings to avoid making others uncomfortable. Those reporting higher social constraints at this stage were more likely to experience loneliness, require more assistance with daily activities, and have greater cognitive difficulties at the one-year mark.
‘The level of social constraint after 90 days was just as effective at predicting overall disability and physical function one year later as the initial severity of the stroke,’ said lead author E. Alison Holman, Ph.D., a professor at the University of California Irvine. She noted that stroke severity is typically considered the primary indicator of recovery potential. The findings suggest that assessing patients’ social environments early in recovery could help identify those at risk for poorer outcomes.
American Stroke Association volunteer expert Amytis Towfighi, M.D., stated that while social support’s benefits are recognized, less is known about how constraints affect recovery. ‘This study is one of the first to assess their influence on long-term psychological, cognitive and functional outcomes,’ said Towfighi, who is also a professor at the Keck School of Medicine of USC. The research offers insights that could inform interventions to improve post-stroke recovery.
The study measured loneliness using items from the UCLA Loneliness Scale and assessed function with the modified Rankin Scale and Montreal Cognitive Assessment. After controlling for factors like age, gender, race, and initial stroke severity, researchers found a clear association between social constraints at three months and recovery levels at one year. Holman emphasized creating ‘a safe space’ for survivors to share feelings if they wish, without forcing conversation.
Patient perspective underscores the findings. Dipika Aggarwal, a neurologist who had a stroke at age 38, described initial isolation followed by transformative sharing. ‘Sharing my story helped me heal. It gave me hope to hear from others and feel less alone,’ said Aggarwal, who now volunteers for the American Stroke Association. She advises survivors to seek support and connect with others who understand their experience.
The research abstract is part of the American Stroke Association International Stroke Conference 2026 Online Program Planner. The American Heart Association’s 2026 statistics indicate stroke is the fourth leading cause of death in the U.S., with resources available at www.stroke.org. The findings are considered preliminary until published in a peer-reviewed journal.
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