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

ABSTRACT

Even mild strokes may affect the patients’ everyday life by impairing cognitive and emotional functions. Our aim was to study predictors of such impairments one year after first-ever mild stroke. We included cognitively healthy patients ≤ 70 years with acute mild stroke. Vascular risk factors, sociodemographic factors and stroke classifications were recorded. At one-year post-stroke, different domains related to cognitive and emotional function were assessed with validated instruments. Logistic regression analyses were performed to identify predictors of cognitive and emotional outcome. Of 117 patient assessed at follow-up, only 21 patients (18%) scored within the reference range on all cognitive and emotional assessments. Younger age, multiple infarcts, and being outside working life at stroke onset were independent predictors of cognitive impairments (psychomotor speed, attention, executive and visuospatial function, memory). Female gender and a higher National Institutes of Health Stroke Scale (NIHSS) score at discharge were significantly associated with emotional impairments (anxiety, depressive symptoms, fatigue, apathy, emotional lability) after one year, but these associations were only seen in the unadjusted models. In conclusion, patients in working age may profit from a follow-up during the post-stroke period, with extra focus on cognitive and emotional functions.

KEYWORDS:

• mild stroke
• younger patients
• predictors
• cognitive impairments
• emotional impairments

Acknowledgements

The authors thank the study’s participants and their relatives. We also thank all who contributed to selecting, examining, and following up the included patients, and among them physicians, nurses, physiotherapists and occupational therapists of the stroke units and the stroke outpatient clinics at Oslo University Hospital and Bærum Hospital. This study was funded by the Department of Geriatric Medicine at Oslo University Hospital.

Author Contributions and Acknowledgements

Concept/idea/research design: B. Fure, G. Vlachos, H. Ihle-Hansen, T.B. Wyller

Writing: All authors

Data collection: G. Vlachos, C. Hamre, H. Ihle-Hansen

Data analysis: G. Vlachos, B. Fure

Project management: B. Fure

Consultation (including review of manuscript before submitting): All authors

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by Department of Geriatric Medicine, Oslo University Hospital.