Relevance of cognition to health-related quality of life in good-outcome survivors of out-of-hospital cardiac arrest

Ørbo, Marte; Aslaksen, Per M.; Larsby, Kristina; Schäfer, Christoph; Tande, Pål M.; Vangberg, Torgil; Anke, Audny

doi:10.2340/16501977-1998

Cited by 38 publications

(35 citation statements)

References 32 publications

(75 reference statements)

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“…3,4 However, residual cognitive impairments are common among these survivors. [5][6][7][8][9][10][11][12][13] Cognitive impairments are associated with a reduction in both health-related quality of life and participation in society. 10,11,14 Memory, attention, and executive functions, as well as fine-motor coordination are most frequently impaired.…”

Section: Introductionmentioning

confidence: 99%

“…Most impairments are mild or moderate. [3][4][5][6][7][8][9][10][11] An increased duration of coma after initial resuscitation 5,6,11,14,15 and an increased duration of time to return of spontaneous circulation (ROSC) 16 have each been correlated with a reduced cognitive outcome; however, other studies do not support these conclusions. 6,13,17 Few previous studies have addressed cognitive outcomes in combination with structural cerebral magnetic resonance imaging (MRI) analytic methods in long-term survivors of cardiac arrest.…”

Section: Introductionmentioning

confidence: 99%

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Cortical Thickness and Cognitive Performance After Out-of-Hospital Cardiac Arrest

Ørbo

Aslaksen

Anke

et al. 2019

Neurorehabil Neural Repair

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Background. Cognitive impairment is common in long-term survivors of out-of-hospital cardiac arrest (OHCA) but corresponding neuroimaging data are lacking. Objectives. This study explored the relationship among the cortical brain structure, cognitive performance, and clinical variables after OHCA. Methods. Three months after resuscitation, 13 OHCA survivors who had recovered from a coma to living independently and 19 healthy controls were assessed by cerebral magnetic resonance imaging and neuropsychological tests quantifying memory, fine-motor coordination, and attention/ executive functions. Cortical thickness (Cth) and surface area (SA) were compared between groups and analyzed for relationships with cognitive performance as well as the clinical variables of coma duration and the time to return of spontaneous circulation (ROSC). All analyses were controlled for age and sex. Results. Analyses of SA revealed no significant differences. Compared with controls, survivors had significantly reduced memory and fine-motor coordination and significantly thinner cortex in large clusters in the frontal, parietal, and inferior temporal cortices, with additional regions in the left occipital lobe and the left temporal lobe. Widespread thinner cortical regions were significantly associated with decreased memory performance in survivors when compared with those in controls and were significantly associated with an increased time to ROSC and increased coma duration in the OHCA group. Increased coma duration, but not increased time to ROSC, was significantly correlated with cognitive test performance. Conclusions. The results suggest that widespread Cth reductions correspond to the cognitive impairments observed after OHCA. Neuroimaging studies of long-term OHCA survivors are warranted to guide the development of diagnostics and treatment options.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cortical Thickness and Cognitive Performance After Out-of-Hospital Cardiac Arrest

Ørbo

Aslaksen

Anke

et al. 2019

Neurorehabil Neural Repair

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“…This leads to a greater susceptibility to changes in cognitive functionality with decreased kidney function. Understanding cognitive dysfunction is critical, as it impacts overall functioning and quality of life in both mental (Fujino et al, 2016;Tan, Thomas, & Rossell, 2014) and physical disorders (Orbo et al, 2015;Schuurs & Green, 2013), and specifically CKD (Seidel et al, 2014;Weiner & Seliger, 2014).…”

Section: Introductionmentioning

confidence: 99%

A Systematic Review of Cognitive Impairments Associated With Kidney Failure in Adults Before Natural Age-Related Changes

Brodski

Rossell

Castle

et al. 2018

J Int Neuropsychol Soc

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Objectives: Recognition of cognitive impairment in chronic kidney disease (CKD) and its impact on functioning in adults is growing. The vast majority of studies to date have been conducted in older populations where CKD is more pronounced; however, the degree to which age-related cognitive changes could be influencing these findings remains unaddressed. This current study thus aimed to review cognitive impairment findings by stage in non-elderly CKD samples. Methods: PubMed and Medline via Scopus were searched for cross-sectional or cohort studies and randomized controlled trials that assessed cognitive function in individuals with CKD in any research setting. CKD studies including patients at any illness stage were included providing participants were below 65 years old, were not on peritoneal dialysis and had not undergone a kidney transplant. Results: Fifteen studies, with a total of 9304 participants, were included. Cognitive function broadly deteriorated from stage 1 to stage 5. Early stage CKD was associated with a drop in speed of processing, attention, response speed, and short-term memory abilities. Moderate stage CKD was associated with deficits in executive functioning, verbal fluency, logical memory, orientation and concentration. People with end stage kidney disease manifested significant deficits in all previous cognitive domains, along with cognitive control, delayed and immediate memory, visuospatial impairment, and overall cognitive impairment. Conclusions: Cognitive impairment is evident across the stages of CKD, independent of age-related changes, for both lower-order and higher-order cognitive abilities. These impairments also increase between the stages, suggesting a cumulative effect. Future directions for research are discussed. (JINS, 2019, 25, 101–114)

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“…7 Both cognitive impairment and emotional problems may affect patients' ability to return to activities in everyday life 1,3,8 and are important determinants of healthrelated quality of life (HRQoL). [9][10][11] Health-related quality of life in CA-survivors is mostly reported to be good and comparable to normative data, but subgroups of survivors have a worse outcome, 11,12 and more than half (56%) of out-of-hospital cardiac arrest (OHCA) survivors in a large Australian study rated their HRQoL to be lower than prearrest. 12 In more descriptive analyses of HRQoL, some areas like vitality 13 and social participation 10,14 were lower for CA-survivors compared with the general population, and in another trial, 74% of OHCA-survivors reported decreased societal participation 1 to 6 years postarrest.…”

mentioning

confidence: 86%

Follow-Up of Cardiac Arrest Survivors: Why, How, and When? A Practical Approach

Lilja

2017

Semin Neurol

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Cardiac arrest (CA) survivors may experience cognitive, physical, or emotional problems that can affect their return to everyday activities and quality of life. To improve long-term outcomes, interventions after hospital discharge may be needed. A follow-up plan to identify CA survivors with increased risk of residual cognitive, physical, or emotional problems is important to target interventions and support. Current recommendations suggest that follow-up should include screening of potential problems, sharing information, and relevant referrals when needed. The complexity of the follow-up of CA survivors is due to the fact that several pathways of care may be offered, focusing either on the cardiovascular disease, the postintensive care syndrome, or CA-related brain injury. There is a potential to improve recovery through a more collaborative and holistic approach to follow-up. The aim of this review is to give examples of follow-up after CA should be provided, but also follow-up could be performed.

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Relevance of cognition to health-related quality of life in good-outcome survivors of out-of-hospital cardiac arrest

Abstract: The cognitive impairments frequently reported in OHCA survivors with good outcomes may compromise health-related quality of life. Cognitive functioning should be addressed even in survivors with rapid recovery.

Cited by 38 publications

References 32 publications

Cortical Thickness and Cognitive Performance After Out-of-Hospital Cardiac Arrest

Cortical Thickness and Cognitive Performance After Out-of-Hospital Cardiac Arrest

A Systematic Review of Cognitive Impairments Associated With Kidney Failure in Adults Before Natural Age-Related Changes

Follow-Up of Cardiac Arrest Survivors: Why, How, and When? A Practical Approach

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