Year: 2016
Type: dissertation
Study design: Observational Study
Abstract: The global burden of stroke is huge and increasing despite significant improvements in acute stroke care in recent decades. The indirect costs, such as productivity losses due to patients inability to return to work after stroke, are a major factor in the accumulation of this burden and are estimated to outweigh the direct costs of stroke. Post-stroke cognitive impairments seem to relate intimately to functional outcomes and quality of life after stroke, but their role in the creation of strokerelated productivity losses remains uncertain. The aim of this study was threefold: to compare the prevalence and severity of post-stroke cognitive impairments in relation to the severity of clinical neurological impairments; to specify the role of cognitive impairments in patients ability to return to work after stroke; and to assess the use of stroke-related income supplements and the role of cognitive impairments in supplement use. A consecutive cohort of 230 working-aged patients with a first-ever ischaemic stroke was enrolled in two Finnish hospitals. The patients underwent repeated neuropsychological assessments in order to describe their cognitive sequelae. Cognitive data from baseline, six-month and two-year follow-up examinations were analysed in relation to demographic, clinical and occupational information on the patients. Cognitive impairments were defined based on the performance of a healthy demographic control group (N =50). Cognitive impairments frequently appeared among otherwise intact patients. After taking into account other relevant factors, baseline cognitive impairments most effectively predicted the return to work of the patients six months after the stroke. Regarding the use of stroke-related income supplements, atrial fibrillation was the most effective health-related predictor, and cognitive impairments the most effective stroke-related predictor. The results of the study emphasize the usefulness of early neuropsychological assessments in treatment planning and the importance of cognitive impairments in the accumulation of post-stroke productivity losses.
Source: Työväentutkimus Vuosikirja
Author: Tatu Kauranen
Language: English
Subfield: Rehabilitation
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2412585677