Cumming Toby B, Brodtmann Amy, Darby David, Bernhardt Julie
Stroke Division, Florey Institute of Neuroscience and Mental Health, Melbourne, 3084, Australia; Department of Florey, University of Melbourne, Melbourne, 3084, Australia.
Stroke Division, Florey Institute of Neuroscience and Mental Health, Melbourne, 3084, Australia; Behavioural Neuroscience Division, Florey Institute of Neuroscience and Mental Health, Melbourne, 3084, Australia; Department of Florey, University of Melbourne, Melbourne, 3084, Australia.
J Psychosom Res. 2014 Nov;77(5):374-9. doi: 10.1016/j.jpsychores.2014.08.009. Epub 2014 Aug 29.
Suffering a stroke typically has a negative impact on a person's quality of life. There is some evidence that post-stroke cognitive impairment is associated with poor quality of life, but the relative importance of deficits in different cognitive domains has not been established.
Patients with confirmed stroke were recruited in the acute hospital. A subgroup of patients completed 2 computerized cognitive tasks (simple and choice reaction time) within 2 weeks of stroke. The full cohort was followed up at 3 months with a comprehensive neuropsychological battery and then at 12 months with the Assessment of Quality of Life ('AQoL).
Sixty patients participated in the study (mean age 72.1 years, SD 13.9), with a subgroup of 33 patients tested acutely (mean age 75.5 years, SD 11.9). Presence of cognitive impairment at 3 months was independently associated with lower quality of life at 12 months (p=0.021). Attention and visuospatial ability were the cognitive domains most closely associated with quality of life. Faster choice reaction time in the acute stage (mean 5.4 days post-stroke) was significantly associated with better quality of life at 12 months (p=0.003).
Cognition, particularly attention and visuospatial ability, is strongly associated with quality of life after stroke. It is possible that straightforward reaction time tasks are sensitive to the extent of brain damage, and might therefore be surrogate markers for quality of life.
中风通常会对人的生活质量产生负面影响。有证据表明中风后认知障碍与生活质量差有关，但不同认知领域缺陷的相对重要性尚未确定。
在急性医院招募确诊为中风的患者。一组患者在中风后2周内完成了2项计算机化认知任务（简单反应时间和选择反应时间）。对整个队列在3个月时进行全面的神经心理测试，然后在12个月时进行生活质量评估（“AQoL”）。
60名患者参与了研究（平均年龄72.1岁，标准差13.9），其中33名患者在急性期进行了测试（平均年龄75.5岁，标准差11.9）。3个月时存在认知障碍与12个月时较低的生活质量独立相关（p = 0.021）。注意力和视觉空间能力是与生活质量最密切相关的认知领域。急性期（中风后平均5.4天）更快的选择反应时间与12个月时更好的生活质量显著相关（p = 0.003）。
认知，特别是注意力和视觉空间能力，与中风后的生活质量密切相关。简单的反应时间任务可能对脑损伤程度敏感，因此可能是生活质量的替代指标。
