Long-term performance of instrumental activities of daily living in young and middle-aged stroke survivors-Impact of cognitive dysfunction, emotional problems and fatigue.

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Blomgren, CharlotteGothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för hälsa och rehabilitering,Institute of Neuroscience and Physiology, Department of Health and Rehabilitation (author)

Long-term performance of instrumental activities of daily living in young and middle-aged stroke survivors-Impact of cognitive dysfunction, emotional problems and fatigue.

Article/chapterEnglish2019

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2019-05-16
Public Library of Science (PLoS),2019

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LIBRIS-ID:oai:gup.ub.gu.se/280673
https://gup.ub.gu.se/publication/280673URI
https://doi.org/10.1371/journal.pone.0216822DOI

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Language:English

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Subject category:art swepub-publicationtype

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With an upward trend in the number of people who return home to independent living after stroke, the ability to perform more complex activities is becoming an increasingly important long-term outcome after stroke. Although associations between Instrumental Activities of Daily Living (IADL) and cognitive dysfunction, emotional problems, and fatigue have been reported, less is known about the long-term impact of these stroke consequences on the performance of everyday activities in young and middle-aged stroke survivors.To explore the impact of cognitive dysfunction, emotional problems, and fatigue on long-term performance of instrumental activities of daily living in young and middle-aged stroke survivors.Data on stroke survivors, aged 18-69 at index stroke, were collected from the Sahlgrenska Academy Study on Ischaemic Stroke. IADL outcome was assessed using the Frenchay Activities Index (FAI), and the impact of chosen variables was assessed using Spearman´s rank-order correlation and logistic regression.Seven years after index stroke, 296 stroke survivors (median age of 64) were included in this study. Cognitive dysfunction showed the strongest correlations with FAI outcome and independently explained worse outcome on FAI summary score and the domain of work/leisure activities. Fatigue was independently explanatory of worse outcome on FAI summary score and domestic chores, while depressive symptoms independently explained worse outcome on work/leisure activities. In a subgroup with only those participants who had no or minimal residual neurological deficits at follow-up (NIHSS score 0), cognitive dysfunction independently explained worse outcome on FAI summary score and work/leisure activities. Depressive symptoms independently explained worse outcome on FAI summary score and domestic chores.Our results show that in young and middle-aged stroke survivors, cognitive dysfunction, depressive symptoms, and fatigue negatively impact performance of IADL even at seven years post stroke onset. Further, we have shown that an impact of both cognitive dysfunction and depressive symptoms can be found also among stroke survivors with mild or no remaining neurological deficits.

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Samuelsson, Hans,1955Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi,Psykologiska institutionen,Institute of Neuroscience and Physiology,Department of Psychology(Swepub:gu)xsamha (author)
Blomstrand, Christian,1942Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi,Institute of Neuroscience and Physiology(Swepub:gu)xbloch (author)
Jern, Christina,1962Gothenburg University,Göteborgs universitet,Institutionen för biomedicin,Institute of Biomedicine(Swepub:gu)xjerch (author)
Jood, Katarina,1966Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi,Institute of Neuroscience and Physiology(Swepub:gu)xjooka (author)
Claesson, Lisbeth,1955Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för hälsa och rehabilitering,Institute of Neuroscience and Physiology, Department of Health and Rehabilitation(Swepub:gu)xclali (author)
Göteborgs universitetInstitutionen för neurovetenskap och fysiologi, sektionen för hälsa och rehabilitering (creator_code:org_t)

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