Donders Institute for Brain, Cognition and Behaviour
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Thesis defence Noortje Maaijwee (Donders Series 181)

12 June 2015

Promotor: Prof.dr. M.A.A.P. Willemsen, Copromotors: Dr. H.F. de Leeuw, dr, E.J.  van Dijk

Long-term neuropsychological and social consequences after stroke in young adults

After a stroke at young age (18-50 years of age), information on long-term consequences is of particular importance for these young patients, given their long life expectancy. Moreover, these young patient are in a phase of life during which they have to make important life changing decisions, for example about career moves or family planning. However, literature on this long-term prognosis in this age group is scarce, especially with repect to neuropsychological and social consequences.

Therefore, the aim of the studies in this thesis was to investigate the long-term neuropsychological and social consequences after a stroke at young age. The studies are part of the FUTURE study, a cohort study, designed to investigate causes and long-term consequences after an ischaemic stroke, transient ischaemic attack (TIA) or intracerebral haemorrhage at young age. The total cohort consists of 1005 patients, admitted to the Radboud University Medical Centre, Nijmegen, between January 1, 1980 and November 1, 2010.

For the studies in this thesis, all patients alive at follow-up with a first-ever ischaemic stroke, TIA or intracerebral haemorraghe were assessed for neuropsychological and social consequences after a mean follow-up duration of approximately 10 years. Results from the studies indicate that long-term neuropsychological consequences (depressive symptoms, anxiety, subjective cognitive failures, objective cognitive impairment, and fatigue) and unemployment are much more prevalent than previously thought, in comparison with an age- and sex-matched control sample without a TIA or stroke in the medical history. Furthermore, the neuropsychological complaints were associated with a higher risk of a poor functional outcome, with dependence in daily life functioning.

Therefore, these neuropsychological and social consequences deserve more attention in post-stroke care than they receive in current clinical practice.