title: Fatigue impact scale demonstrates greater fatigue in younger stroke survivors.
abstract: BACKGROUND
  Fatigue affects 33-77% of stroke survivors. There is no consensus concerning risk factors for fatigue post-stroke, perhaps reflecting the multifaceted nature of fatigue. We characterized post-stroke fatigue using the Fatigue Impact Scale (FIS), a validated questionnaire capturing physical, cognitive, and psychosocial aspects of fatigue.
  
  
  METHODS
  The Stroke Outcomes Study (SOS) prospectively enrolled ischemic stroke patients from 2001-2002. Measures collected included basic demographics, pre-morbid function (Oxford Handicap Scale, OHS), stroke severity (Stroke Severity Scale, SSS), stroke subtype (Oxfordshire Community Stroke Project Classification, OCSP), and discharge function (OHS; Barthel Index, BI). An interview was performed at 12 months evaluating function (BI; Modified Rankin Score, mRS), quality of life (Reintegration into Normal living Scale, RNL), depression (Geriatric Depression Scale, GDS), and fatigue (FIS).
  
  
  RESULTS
  We enrolled 522 ischemic stroke patients and 228 (57.6%) survivors completed one-year follow-up. In total, 36.8% endorsed fatigue (59.5% rated one of worst post-stroke symptoms). Linear regression demonstrated younger age was associated with increased fatigue frequency (β=-0.20;p=0.01), duration (β=-0.22;p<0.01), and disability (β=-0.24;p<0.01). Younger patients were more likely to describe fatigue as one of the worst symptoms post-stroke (β=-0.24;p=0.001). Younger patients experienced greater impact on cognitive (β=-0.27;p<0.05) and psychosocial (β=-0.27;p<0.05) function due to fatigue. Fatigue was correlated with depressive symptoms and diminished quality of life. Fatigue occurred without depression as 49.0% of respondents with fatigue as one of their worst symptoms did not have an elevated GDS.
  
  
  CONCLUSIONS
  Age was the only consistent predictor of fatigue severity at one year. Younger participants experienced increased cognitive and psychosocial fatigue.
authors.affiliation: Department of Medicine, Dalhousie University Halifax, Nova Scotia, Canada.
authors.forename: Natalie E
authors.initials: NE
authors.lastname: Parks
authors.forename: Gail A
authors.initials: GA
authors.lastname: Eskes
authors.forename: Gordon J
authors.initials: GJ
authors.lastname: Gubitz
authors.forename: Yvette
authors.initials: Y
authors.lastname: Reidy
authors.forename: Christine
authors.initials: C
authors.lastname: Christian
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Phillips
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005221:Fatigue / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011788:Quality of Life; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications*; D017741:Survivors / Q000523:psychology*