title: Post-stroke fatigue and its association with poor functional outcome after stroke in young adults.
abstract: BACKGROUND
  Post-stroke fatigue negatively influences short-term functional outcome in older stroke survivors. In young adults, in the midst of their active working and family life, this influence may even be more pronounced. However, there are only few studies on this topic in young patients with stroke. Therefore, we investigated the long-term prevalence of post-stroke fatigue in patients with a young transient ischaemic attack (TIA) or ischaemic stroke and its association with functional outcome.
  
  
  METHODS
  This study is part of a large cohort study among 511 stroke survivors with a first-ever TIA or ischaemic stroke, aged 18-50 years. After a mean follow-up of 9.8 (SD 8.4) years, we assessed the presence of fatigue with the fatigue subscale of the Checklist Individual Strength questionnaire and functional outcome. Prevalence of fatigue between young patients with stroke and 147 stroke-free sex-matched and age-matched controls was compared. OR's for poor functional outcome on modified Rankin Score (mRS>2) and Instrumental Activities of Daily Living (IADL<8) and cognitive performance were calculated using logistic regression analysis.
  
  
  RESULTS
  Of the young patients with stroke, 41% experienced symptoms of fatigue, versus 18.4% in controls (p 0.0005). Fatigue was associated with a poor functional outcome, as assessed by the mRS (OR 4.0 (95% CI 1.6 to 9.6), IADL (OR 2.2 (95% CI 1.1 to 4.6), and impairment in speed of information processing (OR 2.2 (95% CI 1.3 to 3.9).
  
  
  CONCLUSIONS
  Fatigue was very common in young stroke survivors and was associated with a poor functional outcome, even after almost a decade of follow-up.
authors.affiliation: Department of Neurology, Radboud University Nijmegen Medical Centre, The Netherlands, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen, The Netherlands.
authors.forename: Noortje A M M
authors.identifier: http://orcid.org/0000-0002-4041-0245
authors.initials: NA
authors.lastname: Maaijwee
authors.affiliation: Department of Neurology, Radboud University Nijmegen Medical Centre, The Netherlands, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen, The Netherlands.
authors.forename: Renate M
authors.initials: RM
authors.lastname: Arntz
authors.affiliation: Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
authors.forename: Loes C A
authors.initials: LC
authors.lastname: Rutten-Jacobs
authors.affiliation: Department of Neurology, Radboud University Nijmegen Medical Centre, The Netherlands, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen, The Netherlands.
authors.forename: Pauline
authors.initials: P
authors.lastname: Schaapsmeerders
authors.affiliation: Department of Neurology, Radboud University Nijmegen Medical Centre, The Netherlands, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen, The Netherlands.
authors.forename: Henny C
authors.initials: HC
authors.lastname: Schoonderwaldt
authors.affiliation: Department of Neurology, Radboud University Nijmegen Medical Centre, The Netherlands, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen, The Netherlands.
authors.forename: Ewoud J
authors.initials: EJ
authors.lastname: van Dijk
authors.affiliation: Department of Neurology, Radboud University Nijmegen Medical Centre, The Netherlands, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen, The Netherlands.
authors.forename: Frank-Erik
authors.initials: FE
authors.lastname: de Leeuw
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005221:Fatigue / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D009483:Neuropsychological Tests; D015995:Prevalence; D012307:Risk Factors; D020521:Stroke / Q000150:complications* / Q000523:psychology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
keywords: CEREBROVASCULAR DISEASE; EPIDEMIOLOGY; NEUROPSYCHOLOGY; STROKE