Department of Neurology, Dongguk University Gyeongju Hospital, Gyeongju, Korea.
J Stroke. 2013 Jan;15(1):49-56. doi: 10.5853/jos.2013.15.1.49. Epub 2013 Jan 31.
Health-related quality of life (HRQoL) is a multidimensional concept that signifies a subjective evaluation of perceived health; hence, it has gained wide acceptance in geriatrics. However, its application has not been tested in patients with post-stroke cognitive impairment with no dementia (PSCIND). We investigated whether PSCIND interferes with HRQoL measured by EQ-5D, compared the findings to those of healthy people with normal cognition, and evaluated the influence of each cognitive domain on this score.
In total, 1,528 subjects were identified who had undergone neuropsychological assessment using the 60-min protocol of the Korean version of Vascular Cognitive Impairment Harmonization Standards, EQ-5D, and magnetic resonance imaging at the stroke prevention clinic. Fifty PSCIND patients were matched to 50 post-stroke dementia (PSD) patients and 50 normal age- (±3 years) and sex-matched controls. The effects of PSCIND, PSD, and control groups upon the EQ-5Dindex score were tested by generalized estimating equation modeling.
Estimated means±standard errors of EQ-5Dindex scores were as follows: 0.94±0.06 (control group), 0.86±0.08 (PSCIND group), and 0.61±0.32 (PSD group); and the difference among the three groups was statistically significant (P<0.0001). Pairwise comparisons showed that EQ-5Dindex scores in the PSCIND group differed from those in the PSD and control groups (both P<0.01). No cognitive domain was specifically associated with EQ-5Dindex scores after adjusting for functional status.
This study shows that PSCIND may interfere with the quality of life in stroke victims.
健康相关生活质量(HRQoL)是一个多维概念,它表示对感知健康的主观评价;因此,它在老年医学中得到了广泛的认可。然而,它在没有痴呆的卒中后认知障碍(PSCIND)患者中的应用尚未得到验证。我们调查了 PSCIND 是否会干扰 EQ-5D 测量的 HRQoL,将研究结果与认知正常的健康人群进行比较,并评估了每个认知域对该评分的影响。
共有 1528 名受试者在卒中预防诊所接受了神经心理学评估,使用的是韩国版血管性认知障碍协调标准 60 分钟方案、EQ-5D 和磁共振成像。50 名 PSCIND 患者与 50 名卒中后痴呆(PSD)患者和 50 名年龄(±3 岁)和性别匹配的对照组相匹配。通过广义估计方程模型测试 PSCIND、PSD 和对照组对 EQ-5D 指数评分的影响。
EQ-5D 指数评分的估计均值±标准误差如下:0.94±0.06(对照组)、0.86±0.08(PSCIND 组)和 0.61±0.32(PSD 组);三组之间的差异具有统计学意义(P<0.0001)。两两比较显示,PSCIND 组的 EQ-5D 指数评分与 PSD 和对照组均有差异(均 P<0.01)。在调整功能状态后,没有认知域与 EQ-5D 指数评分有特定关联。
本研究表明,PSCIND 可能会干扰卒中患者的生活质量。