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Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Senior Clinical Lecturer Terence J. Quinn, University of Glasgow, United Kingdom
- Second opponent: Adjunct Professor Erik Lundström, Uppsala University, Sweden
- Third member and chair of the evaluation committee: Professor II Cecilie Røe, University of Oslo
Chair of the Defence
Associate Professor Aud Høieggen, University of Oslo
Principal Supervisor
Associate Professor Brynjar Fure, Örebro University, Sweden
Summary
Patients with minimal or no apparent neurological deficits after stroke experience changes in cognitive and emotional functions, which may be invisible for people in their surroundings. Everyday life may be affected, despite the fact that, at discharge from the hospital, everything seemed to have gone well.
The aim of this thesis was to explore such hidden impairments 12 months after a first-ever mild stroke in persons 70 years of age or younger. We have also investigated whether a mild stroke can affect returning to full-time work one year post-stroke. Our research group included 127 previously cognitively healthy patients admitted to two hospitals in Norway. One year later, 117 of them were assessed at the Outpatient stroke clinic for hidden impairments by using validated cognitive and emotional tests.
We found that 2/3 of the patients had difficulties with one or more of the cognitive domains: psychomotor speed, attention, executive and visuospatial function, and visual or verbal memory. Younger age, not working at stroke onset, having diabetes, and multiple stroke lesions were related to such impairments. 43% had either anxiety or depressive symptoms, fatigue, apathy, emotional lability or a combination of those. Female sex and stroke severity may be associated with emotional impairments. 1/3 of the patients had both cognitive and emotional impairments. Only 21 patients were considered to be totally recovered from all stroke symptoms.
Finally, 81% of the patients returned to work one year after stroke, 74% of them to full-time work. Low educational level, female sex, diabetes, fatigue, and low functional level at follow-up were associated with not returning to full-time work.
Overall, hidden impairments are common among patients who have had a mild stroke while in working age. Such patients should be followed up for at least one year after stroke. It should be studied how such invisible symptoms can affect the patients' family and social life.
Additional information
Contact the research support staff.