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The relationship between executive dysfunction and post-stroke mortality: a population-based cohort study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.ORCID iD: 0000-0003-2247-8454
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
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2012 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 2, no 3, e000458- p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES:

To study the associations of pre-stroke cognitive performance with mortality after first-ever stroke or transient ischaemic attack (TIA).

DESIGN:

A prospective cohort study.

SETTING AND PARTICIPANTS:

In participants having first-ever stroke or TIA during up to 14 years of post-test follow-up (n=155), we investigated the associations of pre-stroke variables and cognitive test results with post-stroke survival. The study is based on those participants of the Uppsala Longitudinal Study of Adult Men who performed cognitive function tests at approximately age 70 (n=919).

PRIMARY OUTCOME MEASURES:

Mortality after first-ever stroke or TIA related to pre-stroke executive performance.

RESULTS:

Eighty-four (54%) of the first-ever stroke/TIA patients died under a median follow-up of 2.5 years after the event. In Cox proportional hazard analyses adjusting for age, education, social group and traditional stroke risk factors, poor performance in Trail Making Test (TMT)-A was related to mortality (HR 1.88 per SD, 95% CI 1.31 to 2.71, p=0.001). The risk of mortality was approximately threefold higher in the highest tertile compared with the lowest tertile (HR TMT-A= 2.90 per SD, 95% CI 1.24 to 6.77, p=0.014). A similar pattern was seen for TMT-B, but Mini-Mental State Examination results were not related to risk of post-stroke mortality.

CONCLUSION:

Executive performance measured by TMT-A and -B before stroke was independently associated with long-term risk of mortality, after first-ever stroke or TIA in a population-based study of older men.

Place, publisher, year, edition, pages
2012. Vol. 2, no 3, e000458- p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-181576DOI: 10.1136/bmjopen-2011-000458ISI: 000315044800010PubMedID: 22573701OAI: oai:DiVA.org:uu-181576DiVA: diva2:556859
Available from: 2012-09-26 Created: 2012-09-26 Last updated: 2017-12-07

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Wiberg, BerniceKilander, LenaSundström, JohanByberg, LiisaLind, Lars

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