Influence of socioeconomic status on cognitive outcome after childhood arterial ischemic stroke

Abstract

Aim To determine whether socioeconomic status (SES) is a stronger predictor for cognitive outcome after childhood arterial ischemic stroke compared to clinical factors. Method We investigated perceptual reasoning, executive functions, language, memory, and attention in 18 children and adolescents (12 males, six females, median age at testing 13y 4mo, range 7y–17y 5mo) after arterial ischemic stroke; collected sociodemographic information (education of parents, household income); and used clinical information (initial lesion volume, residual lesion volume, age at stroke, time since stroke). Linear regression models were used to investigate the potential influence of SES and clinical parameters on cognitive abilities. Results SES had a moderate effect on all cognitive outcome parameters except attention by explaining 41.9%, 37.9%, 38.0%, and 22.5% of variability in perceptual reasoning, executive functions, language, and memory respectively. Initial lesion volume was the only clinical parameter that showed moderate importance on cognitive outcome (33.1% and 25.6% of the variability in perceptual reasoning and memory respectively). Overall, SES was a stronger predictor of cognitive outcome than clinical factors. Interpretation Future paediatric studies aiming at clinical predictors of cognitive outcome should control their analyses for SES in their study participants. The findings of the present study further point to the need for more attention to the treatment of children with low SES. What this paper adds Socioeconomic status (SES) explains up to 42% of variance in cognitive outcome after childhood arterial ischemic stroke. SES is a stronger predictor of outcome than clinical factors.

Perinatal inflammation exposure and developmental outcomes 7 years after neonatal arterial ischaemic stroke

“…20 Additionally, childhood socioeconomic status is a strong predictor of child development, 21 and could explain up to 42% of the variance in developmental outcome after childhood arterial ischaemic stroke. 22 As anticipated, children included in our study exposed to perinatal inflammation had a lower median social status score than non-exposed children. Because of the strong association between social status and development, the higher median FSIQ score at 7 years of age in children exposed versus non-exposed to perinatal inflammation was unexpected.…”

“…In this study, maternal inflammation was defined by a composite maternal pro‐inflammatory score, derived from the z‐scores of three cytokine serum concentrations: IL‐6, CRP, and TNF‐α 20 . Additionally, childhood socioeconomic status is a strong predictor of child development, 21 and could explain up to 42% of the variance in developmental outcome after childhood arterial ischaemic stroke 22 . As anticipated, children included in our study exposed to perinatal inflammation had a lower median social status score than non‐exposed children.…”

Fetal temporal sulcus depth asymmetry has prognostic value for language development

“…Educational levels were rated on a 7-point scale for the mother and the father separately, and the family household monthly gross net income was classified on an 11-point scale and rescaled to a 7-point scale. The socioeconomic status was calculated by taking the arithmetic mean of maternal education, paternal education, and household income (see Bartha-Doering et al 69 for more information on the questions and analyses).…”

The influential factors and non-pharmacological interventions of cognitive impairment in children with ischemic stroke

“…The relationship between socioeconomic status and pediatric health has been well-documented over many years ( 34 ). One study found that socioeconomic status was a better predictor of cognitive outcome in childhood arterial ischemic stroke than clinical factors ( 35 ). For example, the financial situation of the family may affect the quantity and quality of treatment, and parental education may be linked to children's cognitive reserve.…”