Long-term cognitive outcome following aneurysmal subarachnoid haemorrhage
Long-term cognitive outcome following aneurysmal subarachnoid haemorrhage
Objectives: Survivors of aneurysmal subarachnoid haemorrhage (aSAH) frequently suffer from cognitive dysfunction. The aim of this study was to assess, in a large sample size with long term follow-up, the characteristics of cognitive dysfunction following aSAH and explore whether cognitive deficits mediate employment outcome. Materials and methods: In this retrospective case-controlled study, aSAH survivors (n = 884) were identified from the UK Biobank and compared to matched controls (n = 3536). Controls were propensity score matched according to age, sex, Townsend deprivation score, educational status and relevant medications known to influence cognition. Cognitive outcomes and employment status were compared between cases and controls using group comparison and cross-tabulation tests. A regression-based mediation analysis was performed to assess whether cognitive deficits mediate employment status following aSAH. Results: Psychomotor reaction time and employment status significantly differed between aSAH cases and controls with slower reaction times (p < 0.001) and more unemployment or inability to work due to illness (p < 0.001) in the aSAH cohort at a mean follow-up of 125 months. Psychomotor slowing was estimated to mediate a significant proportion (6.59%) of the effect of aSAH on employment status. Conclusions: Psychomotor reaction time and employment status differed significantly between aSAH cases and control matched individuals in the UK Biobank. Psychomotor slowing following aSAH had a discernible impact on employment status. Psychomotor reaction time and employment status are practical to acquire and can be used as surrogate measures of outcome in future studies of aSAH survivors.
Cognition, Employment, Outcome, Subarachnoid haemorrhage
Gaastra, Benjamin
c7b7f371-706b-4d59-9150-94e8f254e205
Ewbank, Frederick G.
c5b6e441-c552-4d1a-bfc3-d1c5695e24c7
Tapper, William
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Bulters, Diederik
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Galea, Ian
66209a2f-f7e6-4d63-afe4-e9299f156f0b
January 2022
Gaastra, Benjamin
c7b7f371-706b-4d59-9150-94e8f254e205
Ewbank, Frederick G.
c5b6e441-c552-4d1a-bfc3-d1c5695e24c7
Tapper, William
9d5ddc92-a8dd-4c78-ac67-c5867b62724c
Bulters, Diederik
d6f9644a-a32f-45d8-b5ed-be54486ec21d
Galea, Ian
66209a2f-f7e6-4d63-afe4-e9299f156f0b
Gaastra, Benjamin, Ewbank, Frederick G., Tapper, William, Bulters, Diederik and Galea, Ian
(2022)
Long-term cognitive outcome following aneurysmal subarachnoid haemorrhage.
Journal of Stroke and Cerebrovascular Diseases, 31 (1), [106184].
(doi:10.1016/j.jstrokecerebrovasdis.2021.106184).
Abstract
Objectives: Survivors of aneurysmal subarachnoid haemorrhage (aSAH) frequently suffer from cognitive dysfunction. The aim of this study was to assess, in a large sample size with long term follow-up, the characteristics of cognitive dysfunction following aSAH and explore whether cognitive deficits mediate employment outcome. Materials and methods: In this retrospective case-controlled study, aSAH survivors (n = 884) were identified from the UK Biobank and compared to matched controls (n = 3536). Controls were propensity score matched according to age, sex, Townsend deprivation score, educational status and relevant medications known to influence cognition. Cognitive outcomes and employment status were compared between cases and controls using group comparison and cross-tabulation tests. A regression-based mediation analysis was performed to assess whether cognitive deficits mediate employment status following aSAH. Results: Psychomotor reaction time and employment status significantly differed between aSAH cases and controls with slower reaction times (p < 0.001) and more unemployment or inability to work due to illness (p < 0.001) in the aSAH cohort at a mean follow-up of 125 months. Psychomotor slowing was estimated to mediate a significant proportion (6.59%) of the effect of aSAH on employment status. Conclusions: Psychomotor reaction time and employment status differed significantly between aSAH cases and control matched individuals in the UK Biobank. Psychomotor slowing following aSAH had a discernible impact on employment status. Psychomotor reaction time and employment status are practical to acquire and can be used as surrogate measures of outcome in future studies of aSAH survivors.
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Accepted/In Press date: 17 October 2021
e-pub ahead of print date: 10 November 2021
Published date: January 2022
Additional Information:
Funding Information:
The authors would like to thank: (1) Professor Chi-Hun Kim (Sungkyunkwan University School of Medicine) and Professor Simone Lovestone (University of Oxford) for help with interpreting effects of medications on cognition within UK Biobank; (2) the IRIDIS High Performance Computing Facility, and associated support services at the University of Southampton, which were essential for completion of this work.
Publisher Copyright:
© 2021 Elsevier Inc.
Keywords:
Cognition, Employment, Outcome, Subarachnoid haemorrhage
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Local EPrints ID: 452599
URI: http://eprints.soton.ac.uk/id/eprint/452599
ISSN: 1052-3057
PURE UUID: e2162664-5ee6-4303-8b6e-ce7299f36e61
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Date deposited: 11 Dec 2021 11:28
Last modified: 17 Mar 2024 06:55
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Author:
Frederick G. Ewbank
Author:
Diederik Bulters
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