Cognitive and Functional Outcomes of 5-Year Subarachnoid Haemorrhage Survivors: Comparison to Matched Healthy Controls

Abstract

Background and Purpose: While neuropsychological deficits have been the focus of research post-subarachnoid haemorrhage (SAH), population-based information on long-term neuropsychological impairment post-SAH are lacking. Neither the profile of long-term neuropsychological deficits nor its relationship to long-term functional outcomes has been established. Methods: This was a cross-sectional population-based study of long-term (5 years) neuropsychological and functional outcomes post-SAH. Participants were 27 five-year survivors of SAH previously enrolled in the Auckland Regional Community Stroke study (2002–2003). Twenty-six age-, gender- and ethnicity-matched controls were used to compare mood, functional (i.e. disability; handicap; quality of life, QoL) and neuropsychological outcomes (i.e. verbal memory, visual memory, executive functioning, language, processing speed and visuoperceptual abilities) of SAH survivors. Results: SAH survivors were more depressed and significantly more impaired in the areas of disability, handicap, and QoL than controls. SAH survivors also had significant cognitive deficits across domains when compared to controls. Depressed mood and baseline functioning were related to worse functional outcomes at 5 years post-SAH. Whilst poor cognitive functioning, particularly in the domains of visual memory and language, impacted long-term functional outcomes of SAH survivors. Conclusions: Five-year SAH survivors have many functional and cognitive deficits compared to matched controls. Language and visual memory emerged as independent factors associated with their current functioning.

Health-Related Qol and Lifestyles Are Associated With Cognitive Functions in Elderly People

“…Neuropsychological studies of patients with frontal lesions have reported that impaired executive functions due to frontal-lobe damage are associated with decreasing mental HQOL scores (Chahal, Barker-Collo, & Feigin, 2011;Laffond et al, 2012). In previous psychological studies, executive functions showed a positive correlation with psychological attitudes, including satisfaction with life, gratitude, and forgiveness (Kruger, 2011;Miley & Spinella, 2006), where satisfaction with life is regarded as one component of QOL and as one of the most important components affecting HQOL (McAuley et al, 2008;Pavot & Diener, 1993;Rejeski & Mihalko, 2001;Wrosch & Scheier, 2003).…”

The importance of early brain injury after subarachnoid hemorrhage

“…For many patients and their families, the quality of life is as important as prolongation of life. Consequently, maintenance and recovery of damaged neuronal circuits important for everyday life activities such as cognitive and motor functions, speech and memory could be a better measure of a drug efficacy (Chahal et al , 2011; Hutter et al , 1995; Vieira et al , 2011). Thus, for experimental compounds to become a successful therapy in humans, a therapy that goes beyond prevention of cell death and addresses the acute and delayed deficits that affect quality of life of aSAH victims is required.…”

Long-Term Functioning of Patients with Aneurysmal Subarachnoid Hemorrhage

“…Furthermore, mental slowness and attention deficits are known long-term consequences of A-SAH. 3 Patients who do regain independence for activities of daily life may not be able to resume work, experience difficulties in maintaining and establishing relationships, and report mood disturbances and impaired quality of life 4,5 with long-term anxiety complaints, symptoms of depression, and fatigue. 6,7 However, studies that evaluate the outcomes of SAH survivors beyond the horizon of 1 yr after onset are scarce.…”