Slowed Information Processing Speed at Four Years Poststroke: Evidence and Predictors from a Population-Based Follow-up Study

Susan Mahon; Josh Faulkner; Suzanne Barker-Collo; Rita Krishnamurthi; Kelly Jones; Valery Feigin

doi:10.1016/j.jstrokecerebrovasdis.2019.104513

Slowed Information Processing Speed at Four Years Poststroke: Evidence and Predictors from a Population-Based Follow-up Study

J Stroke Cerebrovasc Dis. 2020 Feb;29(2):104513. doi: 10.1016/j.jstrokecerebrovasdis.2019.104513. Epub 2019 Nov 26.

Authors

Susan Mahon¹, Josh Faulkner², Suzanne Barker-Collo³, Rita Krishnamurthi², Kelly Jones², Valery Feigin²

Affiliations

¹ National Institute for Stroke and Applied Neurosciences, Faculty of Health and Environmental Studies, Auckland University of Technology, Auckland, New Zealand; School of Public Health and Psychosocial Studies, Auckland University of Technology, Auckland, New Zealand. Electronic address: [email protected].
² National Institute for Stroke and Applied Neurosciences, Faculty of Health and Environmental Studies, Auckland University of Technology, Auckland, New Zealand.
³ Department of Psychology, University of Auckland, Auckland, New Zealand.

PMID: 31784380
DOI: 10.1016/j.jstrokecerebrovasdis.2019.104513

Abstract

Background and purpose: Slowed Information Processing Speed (IPS) is a commonly reported cognitive deficit following stroke, affecting up to 50% to 70 % of stroke survivors. IPS has a major influence on poststroke cognitive dysfunction, affecting quality of life and increasing dependence on others. Few studies have examined predictors of slow IPS after stroke, and there is a paucity of data in terms of long-term prevalence. This study examined baseline predictors associated with long-term slow IPS in a population-based stroke incidence cohort, 4 years after stroke onset.

Methods: Adults with stroke (n = 133, m = 71.1 ± 13.5 years) completed the Symbol Digit Modalities Test (SDMT) at 4 years poststroke. Baseline predictors were obtained within 2 weeks of the acute event. Multivariate regression linear and logistic models were used to identify baseline predictors (reported as OR with 95%CI) and prevalence of impaired IPS at 4-years.

Results: 51% of people with stroke had low scores on the SDMT as indicated by a score of -1.0 SD to -2.5 SD (ranging from low to very low respectively). There were significant associations between slow IPS at 4-years after controlling for age and education level and the following baseline factors: older age (>75 years) (OR 3.03, 95% CI .9-9.3,P = .05), previous stroke (OR 2.74, 95% CI 1.0-7.4,P = .05), high cholesterol (OR 2.72, 95% CI 1.3-5.4,p = .01), hypertension (OR 1.82, 95% CI 0.9-3.6,p = .05), and presence of coronary artery disease (OR 3.35, 95% CI 1.6-9.6,P = .01), or arrhythmia (OR 4.40, 95% CI 1.5-12.4,P = .01).

Conclusions: Even after 4-years poststroke, slowed IPS is highly prevalent, with comorbid vascular risk factors significantly contributing to persistent impaired IPS. Early identification of adults who are at higher risk of deficits in IPS is vital to targeting the timely delivery of cognitive rehabilitation interventions, improving overall outcomes.

Keywords: Impaired information processing speed; long-term outcomes; predictors; prevalence; stroke.

MeSH terms

Adult
Aged
Aged, 80 and over
Brain / physiopathology*
Cognition*
Cognitive Dysfunction / epidemiology
Cognitive Dysfunction / physiopathology
Cognitive Dysfunction / psychology
Cognitive Dysfunction / rehabilitation*
Female
Follow-Up Studies
Humans
Male
Middle Aged
New Zealand / epidemiology
Prevalence
Prospective Studies
Recovery of Function
Risk Factors
Stroke / epidemiology
Stroke / physiopathology
Stroke / psychology
Stroke / therapy*
Stroke Rehabilitation*
Time Factors
Treatment Outcome
Young Adult