Prevalence and Predictors of 6-Month Fatigue in Patients With Ischemic Stroke

Abstract

on behalf of the Auckland Regional Community Stroke Study Group Background and Purpose-Although persistent and significant fatigue affects the daily life of stroke survivors, there are no population-based studies examining the prevalence of fatigue in 6-month survivors of ischemic stroke and few studies of predictors of poststroke fatigue. Methods-This article examined data from the Auckland Regional Community Stroke study conducted in Auckland, New Zealand, in 2002. Presence of fatigue was evaluated at 6 months in 613 patients with ischemic stroke using a Short Form 36 Vitality Score (energy and fatigue) of Յ47. Multivariate logistic regression analysis was used to determine predictors of fatigue development 6 months poststroke. Results-The prevalence of fatigue was 30% (28% in men and 33% in women). There was a clear association between increased prevalence of fatigue and advancing age. The only baseline variables independently associated with an increased risk of developing fatigue at 6 months poststroke were prestroke incontinence and being of New Zealand European ethnicity. Being independent and living alone at baseline were associated with significant reduction in the risk of being fatigued at 6 months poststroke. Severe depression at 6 months was significantly and independently associated with being fatigued. Conclusions-The prevalence of fatigue found in our study is at the lower level of range reported in other studies. The prevalence of fatigue increased with advancing age, as found in most previous studies. Because fatigue can have a negative impact on stroke recovery, particular attention needs to be paid to those who are older, incontinent before stroke, and those who report severe symptoms of depression at 6 months after stroke. (Stroke. 2012;43:2604-2609.)

Inflammation and the Silent Sequelae of Stroke

“…Most studies of PSD are cross-sectional; the longitudinal studies that have been done tend to be small and have limited follow-up [4]. Fatigue, defined as a feeling of weariness, tiredness, or lack of energy, affects up to three-quarters of patients who suffer stroke [5][6][7][8][9][10][11][12]. Similar to PSD, most studies of PSF are cross-sectional in design and do not adequately address the natural history of PSF [13].…”

“…PSD also appears to be related to the degree of neurological disability and functional impairment, as well as to the social support network, socioeconomic status, and education [35,36]. Identified risk factors for PSF depend upon the study in question, but depression, female sex, and European ethnicity are often implicated [12]. A relationship between age and PSF is unclear given that some studies show PSF to be more common in younger patients and others show it to be more common in older patients [12,13].…”

“…Identified risk factors for PSF depend upon the study in question, but depression, female sex, and European ethnicity are often implicated [12]. A relationship between age and PSF is unclear given that some studies show PSF to be more common in younger patients and others show it to be more common in older patients [12,13].…”

Determinants of Poststroke Fatigue among Stroke Survivors Undergoing Rehabilitation in Nigeria

“…While many of the previous studies that investigated the determinants of PSF have reported conflicting and inconclusive findings, the impact of level of functional ability (or disability) appears be fairly consistent across studies (4,15,17,22,23). A recent systematic review of PSF literature showed that 25 studies found a significant association between PSF and functional ability while 15 studies did not (4).…”

“…There is however a need for countryspecific data especially as there are reports on association between race/ethnicity and fatigue (16,17). To bridge the existing gap in the literature, this study therefore examined determinants of PSF among stroke survivors undergoing physiotherapy on outpatient basis in Nigeria.…”