Abstract TP438: Reaction Time In Acute Stroke Predicts Long-Term Quality Of Life
Introduction—Post-stroke cognitive impairment has a negative impact on quality of life. Little is known, however, about the relative importance of different cognitive domains, or whether cognitive markers in acute stroke can be prognostic for longer term outcomes.
Hypothesis—We hypothesised that processing speed and attention would be the strongest predictors of long-term quality of life.
Methods—Patients with confirmed stroke were followed up at 3 months with a full neuropsychological battery and at 12 months with the Assessment of Quality of Life (AQoL) and the modified Rankin Scale (mRS). A subgroup of these patients was assessed over the year (acute stage, 3 months, 12 months) on 2 computerised cognitive tasks: simple and choice reaction time.
Results—Sixty patients participated in the study [mean age 72.1 years (SD=13.9), mean education 10.5 years (SD=3.9), mean NIHSS 5.8 (SD=4.0)]; a subgroup of 33 received the computerised tasks. Cognitive domains at 3 months that were significant predictors of 12-month AQoL were attention (p = 0.002), executive function (p = 0.005) and visuospatial ability (p = 0.009), but not memory or language. Subgroup data indicated that choice reaction time in the acute stage was a significant independent predictor of 12-month AQoL (p = 0.01). Acute reaction times were significantly correlated with mRS at 12 months (r > 0.50), and were not simply a proxy for stroke severity (they were not correlated with acute NIHSS and did not improve significantly across time).
Conclusions—Attention, executive and visuospatial function are important contributors to quality of life after stroke. Speed of processing within a week of stroke is predictive of long-term quality of life, raising the possibility that straightforward reaction time tasks can reveal the extent of disruption to the brain’s network.
- © 2012 by American Heart Association, Inc.