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Research paper
Post-stroke fatigue and its association with poor functional outcome after stroke in young adults
  1. Noortje A M M Maaijwee1,
  2. Renate M Arntz1,
  3. Loes C A Rutten-Jacobs2,
  4. Pauline Schaapsmeerders1,
  5. Henny C Schoonderwaldt1,
  6. Ewoud J van Dijk1,
  7. Frank-Erik de Leeuw1
  1. 1Department of Neurology, Radboud University Nijmegen Medical Centre, The Netherlands, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen, The Netherlands
  2. 2Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
  1. Correspondence to Dr Frank-E de Leeuw, Department of Neurology, Radboud University Nijmegen Medical Centre, P.O. Box 9101, Nijmegen 6500 HB, The Netherlands; frankerik.deleeuw{at}


Introduction Post-stroke fatigue negatively influences short-term functional outcome in older stroke survivors. In young adults, in the midst of their active working and family life, this influence may even be more pronounced. However, there are only few studies on this topic in young patients with stroke. Therefore, we investigated the long-term prevalence of post-stroke fatigue in patients with a young transient ischaemic attack (TIA) or ischaemic stroke and its association with functional outcome.

Methods This study is part of a large cohort study among 511 stroke survivors with a first-ever TIA or ischaemic stroke, aged 18–50 years. After a mean follow-up of 9.8 (SD 8.4) years, we assessed the presence of fatigue with the fatigue subscale of the Checklist Individual Strength questionnaire and functional outcome. Prevalence of fatigue between young patients with stroke and 147 stroke-free sex-matched and age-matched controls was compared. OR's for poor functional outcome on modified Rankin Score (mRS>2) and Instrumental Activities of Daily Living (IADL<8) and cognitive performance were calculated using logistic regression analysis.

Results Of the young patients with stroke, 41% experienced symptoms of fatigue, versus 18.4% in controls (p 0.0005). Fatigue was associated with a poor functional outcome, as assessed by the mRS (OR 4.0 (95% CI 1.6 to 9.6), IADL (OR 2.2 (95% CI 1.1 to 4.6), and impairment in speed of information processing (OR 2.2 (95% CI 1.3 to 3.9).

Conclusions Fatigue was very common in young stroke survivors and was associated with a poor functional outcome, even after almost a decade of follow-up.


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