title: Ischaemic stroke at a young age is a serious event--final results of a population-based long-term follow-up in Western Norway.
abstract: OBJECTIVE
  Our population-based long-term follow-up of young ischaemic stroke patients and controls showed 10-fold increased mortality and fivefold increased arterial event rate nearly 12 years after study inclusion. We now assess memory, anxiety, depression and sleep in relation to employment and functional outcome, treatment goals and results from a last alive-dead survey.
  
  
  METHODS
  Patients (n = 232) ≤ 49 years with an index-stroke between 1988 and 1997 were retrospectively selected and compared with age- and sex-matched controls (n = 453). At follow-up from 2004 to 2005, 144 (77%) of 187 patients were clinically examined. Self-assessment information about memory problems, anxiety, depression, sleeping problems, education and employment was compared with answers from standardized questionnaires from 167 controls. Functional outcome was measured by the modified Rankin Scale (mRS).
  
  
  RESULTS
  Patients compared with controls had more memory problems (41.0% vs. 5.4%, P < 0.001), anxiety (19.4% vs. 9%, P = 0.009), depression (29.2% vs. 13.2%, P = 0.001) and sleeping problems (36.1% vs. 19.2%, P = 0.001). In the multiple regression analysis male gender (OR 9.3, 95%CI 0.10-0.61, P = 0.002), normal memory (OR 12.7, 95%CI 0.07-0.47, P < 0.001) and mRS 0-1 (OR 15.7, 95%CI 0.002-0.12, P < 0.001) were factors for full-time employment. Blood pressure was < 140/90 mmHg in 39% of patients, 49% stopped smoking and 38.2% used statins. After a mean observation time of 18.3 years, 63 (27.2%) of 232 patients were dead.
  
  
  CONCLUSIONS
  Our data show a heterogeneous prognosis and high mortality even for long-time survivors of ischaemic stroke at a young age. Prospective studies of young stroke patients and controls are necessary for direct comparison.
authors.affiliation: Department of Neurology, Haukeland University Hospital, Bergen, Norway. uwan@helse-bergen.no
authors.forename: U
authors.initials: U
authors.lastname: Waje-Andreassen
authors.forename: L
authors.initials: L
authors.lastname: Thomassen
authors.forename: M
authors.initials: M
authors.lastname: Jusufovic
authors.forename: K N
authors.initials: KN
authors.lastname: Power
authors.forename: G E
authors.initials: GE
authors.lastname: Eide
authors.forename: C A
authors.initials: CA
authors.lastname: Vedeler
authors.forename: H
authors.initials: H
authors.lastname: Naess
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001007:Anxiety / Q000150:complications; D002545:Brain Ischemia / Q000150:complications*; D016022:Case-Control Studies; D003863:Depression / Q000150:complications; D004522:Educational Status; D004651:Employment; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D008569:Memory Disorders / Q000150:complications; D008875:Middle Aged; D009664:Norway; D011379:Prognosis; D020127:Recovery of Function; D012189:Retrospective Studies; D012727:Sex Characteristics; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications; D020521:Stroke / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality* / Q000523:psychology*
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors