Predictors of cognitive and emotional symptoms 12 months after first-ever mild stroke

Vlachos, Georgios; Ihle‐Hansen, Hege; Wyller, Torgeir Bruun; Brækhus, Anne; Mangset, Margrete; Hamre, Charlotta; Fure, Brynjar

doi:10.1080/09602011.2022.2038211

Cited by 4 publications

(9 citation statements)

References 59 publications

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“…27 Occupation was tested in 16 studies. 12,[23][24][25]28,29,35,[39][40][41][42][43]45,46,50,52 Occupational categories such as professionals and skilled workers were considered to have a higher SES, while those who were unemployed, retired, unskilled, or engaged in manual occupations had a lower SES. Boutros et al classified occupation into persons without any profession or retired, unemployment, and employed.…”

Section: Socioeconomic Status Measurementmentioning

confidence: 99%

“…A total of 17 studies provided data on stroke severity on admission, 13 of which were assessed using the National Institutes of Health Stroke Scale. 26,27,29,30,[34][35][36][37][38][39][40][41][42] Fourteen studies only enrolled participants who experienced their first-time stroke, 12,28,31,34,36,39,40,[42][43][44][45][46][47][48] and 16 studies included participants with stroke history. [24][25][26][27]29,32,33,37,38,41,[49][50][51][52][53][54] Two studies did not restrict the stroke history of the participants, but they also provided another set of data specific to first-time stroke patients.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Premorbid cognitive impairment and dementia were screened in most studies. Twenty-eight studies excluded patients with pre-stroke cognitive impairment or dementia, 12,[23][24][25][26][27][28][29][30][31][32][34][35][36][37][38][39][40][41][42][43][44][46][47][48]50,51,53 either by medical history or by certain cognitive tests. One study provided the incidence of pre-stroke cognitive impairment.…”

Section: Cognitive Measurementmentioning

confidence: 99%

“…49 Five studies did not mention the exclusion of prior cognitive impairment or dementia patients at baseline. 33,45,52,54,55 On account of the cognitive outcomes, a total of 19 studies provided data on PSCI as the outcome, 12,27,28,[33][34][35][36][37][38][39][40]42,43,45,46,[48][49][50]52 13 reported PSD as the outcome. [24][25][26]29,30,32,41,44,47,51,[53][54][55] One study reported both PSCI and PSD.…”

Section: Cognitive Measurementmentioning

confidence: 99%

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Association of socioeconomic status and poststroke cognitive function: A systematic review and meta‐analysis

Tian,

Wang,

Guo

et al. 2024

Int J Geriat Psychiatry

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BackgroundStroke survivors are at high risk of coping with cognitive problems after stroke. In recent decades, the relationship between socioeconomic status (SES) and health‐related outcomes has been a topic of considerable interest. Learning more about the potential impact of SES on poststroke cognitive dysfunction is of great importance.ObjectiveThe purpose of this systematic review and meta‐analysis was to summarize the association between SES and poststroke cognitive function by quantifying the effect sizes of the existing studies.MethodWe searched studies from PubMed, Ovid, Embase, Cochrane, Scopus, and PsychINFO up to January 30th 2024 and the references of relevant reviews. Studies reporting the risk of poststroke cognitive dysfunction as assessed by categorized SES indicators were included. The Newcastle‐Ottawa scale and the Agency for Healthcare Research and Quality were used to evaluate the study quality. Meta‐analyses using fixed‐effect models or random‐effect models based on study heterogeneity were performed to estimate the influence of SES on cognitive function after stroke, followed by subgroup analyses stratified by study characteristics.ResultsThirty‐four studies were eligible for this systematic review and meta‐analysis. Of which, 19 studies reported poststroke cognitive impairment (PSCI) as the outcome, 13 reported poststroke dementia (PSD), one reported both PSCI and PSD, and one reported vascular cognitive impairment no dementia. The findings showed that individuals with lower SES levels had a higher risk of combined poststroke cognitive dysfunction (odds ratio (OR) = 1.91, 95% confidence interval (CI) = 1.59–2.29), PSCI (OR = 2.09, 95% CI = 1.57–2.78), and PSD (OR = 1.95, 95% CI = 1.48–2.57). Subgroup analyses stratified by SES indicators demonstrated the protective effects of education and occupation against the diagnoses of combined poststroke cognitive dysfunction, PSCI, and PSD.ConclusionsStroke survivors belonging to a low SES are at high risk of poststroke cognitive dysfunction. Our findings add evidence for public health strategies to reduce the risk of poststroke cognitive dysfunction by reducing SES inequalities.

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Section: Socioeconomic Status Measurementmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Cognitive Measurementmentioning

confidence: 99%

Section: Cognitive Measurementmentioning

confidence: 99%

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Association of socioeconomic status and poststroke cognitive function: A systematic review and meta‐analysis

Tian,

Wang,

Guo

et al. 2024

Int J Geriat Psychiatry

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“…Both daytime sleep and fatigue are multidimensional stroke sequelae, and their development may be best predicted by a complex interplay between various factors. In clinical practice it is typically difficult to distinguish self-reported psychiatric and cognitive symptoms from each other, and patients reporting these symptoms may experience such problems as a more general feeling of being somewhat different compared to before the stroke ( 36 ). Such self-reported symptoms may therefore reflect increased mental distress in these patients, and studying the role of self-reported mental distress in predicting fatigue and daytime sleep post-stroke may help to increase our understanding of the etiology of these stroke sequelae.…”

Section: Introductionmentioning

confidence: 99%

Self-reported cognitive and psychiatric symptoms at 3 months predict single-item measures of fatigue and daytime sleep 12 months after ischemic stroke

et al. 2022

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IntroductionPost-stroke fatigue and increased need for daytime sleep are multidimensional and insufficiently understood sequelae. Our aim was to study the relationships of self-reported cognitive and psychiatric symptoms at 3 months with fatigue and daytime sleep at 12 months post-stroke.MethodsIschemic stroke patients without reported history of dementia or depression completed postal surveys 3- and 12-months post-stroke. At 3 months, psychiatric symptoms were assessed with the Hospital Anxiety and Depression Scale (HADS), and self-reported changes in cognitive symptoms (concentration and memory) compared to pre-stroke were assessed using single-item measures. At 12 months, single-item questions about changes in self-reported difficulties sleeping at night, fatigue and daytime sleep were included. First, we studied whether self-reported cognitive and/or psychiatric symptoms at 3 months were associated with daytime sleep and fatigue at 12 months using multiple logistic regression. Second, we fitted 2 structural equation models (SEMs) predicting fatigue and 2 models predicting daytime sleep. We compared a model where only age, sex, stroke severity (National Institutes of Health Stroke Scale; NIHSS), and difficulties sleeping at night predicted fatigue and daytime sleep at 12 months to a model where mental distress (i.e., a latent variable built of cognitive and psychiatric symptoms) was included as an additional predictor of fatigue and daytime sleep at 12 months.ResultsOf 156 patients (NIHSS within 24 hours after admission (mean ± SD) = 3.6 ± 4.3, age = 73.0 ± 10.8, 41% female) 37.9% reported increased daytime sleep and 50.0% fatigue at 12 months. Increased psychiatric symptoms and worsened cognitive symptoms were associated with fatigue and daytime sleep at 12 months, after controlling for NIHSS, age, sex, and difficulties sleeping at night. SEM models including mental distress as predictor showed adequate model fit across 3 fit measures (highest RMSEA = 0.063, lowest CFI and TLI, both 0.975). Models without mental distress were not supported.ConclusionSelf-reported cognitive and psychiatric symptoms at 3 months predict increased daytime sleep and fatigue at 12 months. This highlights the relevance of monitoring cognitive and psychiatric symptoms in the subacute phase post-stroke. However, future research using validated measures of self-reported symptoms are needed to further explore these relationships.

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Factors Determining Not Returning to Full-Time Work 12 Months After Mild Ischemic Stroke

Vlachos¹,

Ihle‐Hansen²,

Wyller³

et al. 2023

Archives of Rehabilitation Research and Clinical Translation

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Predictors of cognitive and emotional symptoms 12 months after first-ever mild stroke

Cited by 4 publications

References 59 publications

Association of socioeconomic status and poststroke cognitive function: A systematic review and meta‐analysis

Association of socioeconomic status and poststroke cognitive function: A systematic review and meta‐analysis

Self-reported cognitive and psychiatric symptoms at 3 months predict single-item measures of fatigue and daytime sleep 12 months after ischemic stroke

Factors Determining Not Returning to Full-Time Work 12 Months After Mild Ischemic Stroke

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