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Post-stroke Fatigue and Depressive Symptoms Are Differentially Related to Mobility and Cognitive Performance

Background: Fatigue and depressive symptoms are common and often inter-related stroke sequelae. This study investigates how they are related, directly or indirectly, to mobility and cognitive outcomes within 6 months of stroke. Methods: Participants were recruited from 4 stroke centers in Ontario, C...

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Autores principales: MacIntosh, Bradley J., Edwards, Jodi D., Kang, Mani, Cogo-Moreira, Hugo, Chen, Joyce L., Mochizuki, George, Herrmann, Nathan, Swardfager, Walter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5671553/
https://www.ncbi.nlm.nih.gov/pubmed/29163127
http://dx.doi.org/10.3389/fnagi.2017.00343
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author MacIntosh, Bradley J.
Edwards, Jodi D.
Kang, Mani
Cogo-Moreira, Hugo
Chen, Joyce L.
Mochizuki, George
Herrmann, Nathan
Swardfager, Walter
author_facet MacIntosh, Bradley J.
Edwards, Jodi D.
Kang, Mani
Cogo-Moreira, Hugo
Chen, Joyce L.
Mochizuki, George
Herrmann, Nathan
Swardfager, Walter
author_sort MacIntosh, Bradley J.
collection PubMed
description Background: Fatigue and depressive symptoms are common and often inter-related stroke sequelae. This study investigates how they are related, directly or indirectly, to mobility and cognitive outcomes within 6 months of stroke. Methods: Participants were recruited from 4 stroke centers in Ontario, Canada. Post-stroke fatigue was assessed using the Fatigue Assessment Scale (FAS). Depressive symptoms were screened using the Center for Epidemiological Studies Scale for Depression (CES-D). Factor analyses were used to construct scores from mobility (distance traveled during a 2-min walk test, Chedoke-McMaster Stroke Assessment leg score, and Berg Balance Scale total score) and cognitive (Montreal Cognitive Assessment, Trail-Making Tests A and B, and five-word free recall) tests. Direct associations were assessed in linear regression models and indirect effects were assessed in path models. Covariates were age, sex, education, antidepressant use, days since stroke, and stroke severity (National Institute of Health Stroke Severity Scale score). Results: Fatigue and depressive symptoms were highly correlated (r > 0.51, p < 0.0001). Depressive symptoms were associated with cognition (β = −0.184, p = 0.04) and indirectly with mobility, mediated by fatigue (indirect effect = −0.0142, 95% CI: −0.0277 to −0.0033). Fatigue was associated with mobility (β = −0.253, p = 0.01), and indirectly with cognition, mediated by depressive symptoms (indirect effect = −0.0113, 95% CI: −0.0242 to −0.0023). Conclusions: Fatigue and depressive symptoms are related distinctly to cognitive and mobility impairments post-stroke. Fatigue was associated with poorer lower limb motor function, and with cognition indirectly via depressive symptoms.
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spelling pubmed-56715532017-11-21 Post-stroke Fatigue and Depressive Symptoms Are Differentially Related to Mobility and Cognitive Performance MacIntosh, Bradley J. Edwards, Jodi D. Kang, Mani Cogo-Moreira, Hugo Chen, Joyce L. Mochizuki, George Herrmann, Nathan Swardfager, Walter Front Aging Neurosci Neuroscience Background: Fatigue and depressive symptoms are common and often inter-related stroke sequelae. This study investigates how they are related, directly or indirectly, to mobility and cognitive outcomes within 6 months of stroke. Methods: Participants were recruited from 4 stroke centers in Ontario, Canada. Post-stroke fatigue was assessed using the Fatigue Assessment Scale (FAS). Depressive symptoms were screened using the Center for Epidemiological Studies Scale for Depression (CES-D). Factor analyses were used to construct scores from mobility (distance traveled during a 2-min walk test, Chedoke-McMaster Stroke Assessment leg score, and Berg Balance Scale total score) and cognitive (Montreal Cognitive Assessment, Trail-Making Tests A and B, and five-word free recall) tests. Direct associations were assessed in linear regression models and indirect effects were assessed in path models. Covariates were age, sex, education, antidepressant use, days since stroke, and stroke severity (National Institute of Health Stroke Severity Scale score). Results: Fatigue and depressive symptoms were highly correlated (r > 0.51, p < 0.0001). Depressive symptoms were associated with cognition (β = −0.184, p = 0.04) and indirectly with mobility, mediated by fatigue (indirect effect = −0.0142, 95% CI: −0.0277 to −0.0033). Fatigue was associated with mobility (β = −0.253, p = 0.01), and indirectly with cognition, mediated by depressive symptoms (indirect effect = −0.0113, 95% CI: −0.0242 to −0.0023). Conclusions: Fatigue and depressive symptoms are related distinctly to cognitive and mobility impairments post-stroke. Fatigue was associated with poorer lower limb motor function, and with cognition indirectly via depressive symptoms. Frontiers Media S.A. 2017-10-31 /pmc/articles/PMC5671553/ /pubmed/29163127 http://dx.doi.org/10.3389/fnagi.2017.00343 Text en Copyright © 2017 MacIntosh, Edwards, Kang, Cogo-Moreira, Chen, Mochizuki, Herrmann and Swardfager. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neuroscience
MacIntosh, Bradley J.
Edwards, Jodi D.
Kang, Mani
Cogo-Moreira, Hugo
Chen, Joyce L.
Mochizuki, George
Herrmann, Nathan
Swardfager, Walter
Post-stroke Fatigue and Depressive Symptoms Are Differentially Related to Mobility and Cognitive Performance
title Post-stroke Fatigue and Depressive Symptoms Are Differentially Related to Mobility and Cognitive Performance
title_full Post-stroke Fatigue and Depressive Symptoms Are Differentially Related to Mobility and Cognitive Performance
title_fullStr Post-stroke Fatigue and Depressive Symptoms Are Differentially Related to Mobility and Cognitive Performance
title_full_unstemmed Post-stroke Fatigue and Depressive Symptoms Are Differentially Related to Mobility and Cognitive Performance
title_short Post-stroke Fatigue and Depressive Symptoms Are Differentially Related to Mobility and Cognitive Performance
title_sort post-stroke fatigue and depressive symptoms are differentially related to mobility and cognitive performance
topic Neuroscience
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5671553/
https://www.ncbi.nlm.nih.gov/pubmed/29163127
http://dx.doi.org/10.3389/fnagi.2017.00343
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