Ben Gaastra1, Frederick Ewbank2, William Tapper3, Diederik Bulters2, Ian Galea4. 1. Department of Neurosurgery, Wessex Neurological Centre, University Hospital Southampton, Southampton SO16 6YD, UK; Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK. 2. Department of Neurosurgery, Wessex Neurological Centre, University Hospital Southampton, Southampton SO16 6YD, UK. 3. Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK. 4. Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK. Electronic address: i.galea@soton.ac.uk.
Abstract
OBJECTIVES: Survivors of aneurysmal subarachnoid haemorrhage (aSAH) frequently suffer from cognitive dysfunction. The aim of this study was to assess, in a large sample size with long term follow-up, the characteristics of cognitive dysfunction following aSAH and explore whether cognitive deficits mediate employment outcome. MATERIALS AND METHODS: In this retrospective case-controlled study, aSAH survivors (n = 884) were identified from the UK Biobank and compared to matched controls (n = 3536). Controls were propensity score matched according to age, sex, Townsend deprivation score, educational status and relevant medications known to influence cognition. Cognitive outcomes and employment status were compared between cases and controls using group comparison and cross-tabulation tests. A regression-based mediation analysis was performed to assess whether cognitive deficits mediate employment status following aSAH. RESULTS: Psychomotor reaction time and employment status significantly differed between aSAH cases and controls with slower reaction times (p < 0.001) and more unemployment or inability to work due to illness (p < 0.001) in the aSAH cohort at a mean follow-up of 125 months. Psychomotor slowing was estimated to mediate a significant proportion (6.59%) of the effect of aSAH on employment status. CONCLUSIONS: Psychomotor reaction time and employment status differed significantly between aSAH cases and control matched individuals in the UK Biobank. Psychomotor slowing following aSAH had a discernible impact on employment status. Psychomotor reaction time and employment status are practical to acquire and can be used as surrogate measures of outcome in future studies of aSAH survivors.
OBJECTIVES: Survivors of aneurysmal subarachnoid haemorrhage (aSAH) frequently suffer from cognitive dysfunction. The aim of this study was to assess, in a large sample size with long term follow-up, the characteristics of cognitive dysfunction following aSAH and explore whether cognitive deficits mediate employment outcome. MATERIALS AND METHODS: In this retrospective case-controlled study, aSAH survivors (n = 884) were identified from the UK Biobank and compared to matched controls (n = 3536). Controls were propensity score matched according to age, sex, Townsend deprivation score, educational status and relevant medications known to influence cognition. Cognitive outcomes and employment status were compared between cases and controls using group comparison and cross-tabulation tests. A regression-based mediation analysis was performed to assess whether cognitive deficits mediate employment status following aSAH. RESULTS: Psychomotor reaction time and employment status significantly differed between aSAH cases and controls with slower reaction times (p < 0.001) and more unemployment or inability to work due to illness (p < 0.001) in the aSAH cohort at a mean follow-up of 125 months. Psychomotor slowing was estimated to mediate a significant proportion (6.59%) of the effect of aSAH on employment status. CONCLUSIONS: Psychomotor reaction time and employment status differed significantly between aSAH cases and control matched individuals in the UK Biobank. Psychomotor slowing following aSAH had a discernible impact on employment status. Psychomotor reaction time and employment status are practical to acquire and can be used as surrogate measures of outcome in future studies of aSAH survivors.
Authors: Ben Gaastra; Sheila Alexander; Mark K Bakker; Hemant Bhagat; Philippe Bijlenga; Spiros L Blackburn; Malie K Collins; Sylvain Doré; Christoph J Griessenauer; Philipp Hendrix; Eun Pyo Hong; Isabel C Hostettler; Henry Houlden; Koji IIhara; Jin Pyeong Jeon; Bong Jun Kim; Jiang Li; Sandrine Morel; Paul Nyquist; Dianxu Ren; Ynte M Ruigrok; David Werring; Will Tapper; Ian Galea; Diederik Bulters Journal: Transl Stroke Res Date: 2022-10-20 Impact factor: 6.800
Authors: Ian Galea; Diederik Bulters; Will Tapper; Ben Gaastra; Sheila Alexander; Mark K Bakker; Hemant Bhagat; Philippe Bijlenga; Spiros Blackburn; Malie K Collins; Sylvain Doré; Christoph Griessenauer; Philipp Hendrix; Eun Pyo Hong; Isabel C Hostettler; Henry Houlden; Koji IIhara; Jin Pyeong Jeon; Bong Jun Kim; Munish Kumar; Sandrine Morel; Paul Nyquist; Dianxu Ren; Ynte M Ruigrok; David Werring Journal: Transl Stroke Res Date: 2022-01-06 Impact factor: 6.800