The State's first purpose-designed stroke unit, located in a Limerick hospital where author Frank McCourt once recovered from typhoid, complements a series of research projects in the area on the links between ageing and illness.
Prof Declan Lyons, a medical consultant, said the new £650,000 Rehabilitation Centre at St Camillus Hospital, which was officially opened this week, would treat the single biggest cause of adult disability in the Republic.
He recalled that the young McCourt was discharged from the hospital "with my weak legs" after a second episode of typhoid fever almost 60 years ago.
The building, a workhouse in the 19th century and a fever hospital in the 1930s and 1940s, now has a combination of tradition and modern technology.
The stroke unit is supported by two consultants, physiotherapists, occupational therapists and speech and language therapists. A group of specialist registrars at the centre rotate their training at Kings College Hospital, London.
There would be a throughput of more than 200 patients annually, he estimated, about half of all stroke patients in the Mid-Western Health Board area. "The evidence at the moment is that if you have a stroke and if you are managed or looked after in a stroke unit as opposed to an ordinary medical ward, you will reduce your risk of dying, of living with a permanent disability and of being institutionalised in a hospital or a nursing home.
"Stroke units can reduce death or disability by about 30 per cent." While other hospitals, such as Tallaght and Beaumont have stroke services, they do not have specially built facilities. "The success of stroke units is probably due to better organisation of stroke care, the development of expertise in the management of stroke patients and in the implementation of preventative strategies for future stroke."
The design features extra space for patients, ready access to the physiotherapy gymnasium and other facilities, and a pleasant ambience. "The last thing you want when you have the potential for a life-long disability is for you to be asked to recover in an environment that is less than optimum," he said.
In the Republic, there is no register of people with acute stroke but more than 8,000 acute cases occur annually and in-hospital mortality is at about 20 per cent. There are 30,000 people with residual disabilities from the illness which usually occurs as a result of a blood clot in the brain.
Prof Lyons said medical gerontology, the science of ageing, was a field he was always interested in. From Limerick, he studied medicine at UCD and did an MD in pharmacology and medical gerontology at Aberdeen before being appointed a consultant and senior lecturer at Kings College Hospital.
Understanding why disease "clusters" in old age and why physiological methods go wrong requires different methods of evaluating age scientifically, he said. "There is no question but that ageing is the single biggest challenge facing any modern healthcare system.
"While people in the midwest over the age of 65 represent only 11 per cent of the population, they are using in excess of half of all acute medical resources, not to mention all the medical facilities such as stroke units, rehabilitation units and continuing care facilities," he said.
Next month, a College of Health Sciences and Management will be opened as a collaborative project with the University of Limerick. Its purpose will be to support the biomedical research initiatives being undertaken in the region.
"There is a very big and extensive research programme going on now in the whole area of ageing at the Regional Hospital, where the specialist areas of interest are in the pharmacology of ageing, and blood vessel dysfunction as a cause of diseases in advancing age."
Limerick has a clinical age assessment unit with specialist diagnostic equipment, a DEXA scanner used for the diagnosis of osteoporosis and the determination of bone fragility, and a dedicated "syncope" laboratory which researches falls and dizzy turns, "one of the most common complaints presented to accident and emergency departments".
"One of the last things that a child learns to do is to maintain an upright posture and walk. Very often this is one of the first things to become impaired with advancing age and is a major cause for institutionalisation. The combination of bone fragility and syncope is lethal," Prof Lyons said.