title: Quality of Life after Young Ischemic Stroke of Mild Severity Is Mainly Influenced by Psychological Factors.
abstract: BACKGROUND
  Long-term prognosis in terms of quality of life (QoL) in young stroke patients is of importance because they usually have a long life expectancy and extensive daily life demands. We aimed at determining which medical and psychological factors influence the QoL in young stroke patients (<50 years), after long-term follow-up.
  
  
  METHODS
  Young ischemic stroke patients admitted to the St. Elisabeth Hospital and the TweeSteden Hospital, Tilburg, the Netherlands, between 2000 and 2010 were included. One hundred seventy patients and 61 controls filled out the following questionnaires: (1) the Hospital Anxiety and Depression Scale, (2) the Fatigue Assessment Scale, and (3) the shortened World Health Organization Quality of Life scale. Using linear multiple regression analysis, we assessed the factors influencing QoL.
  
  
  RESULTS
  QoL did not differ significantly between patients (median modified Rankin Scale score at follow-up, 0) and controls after a mean follow-up of 4.5 (standard deviation, 2.8) years. The presence of excessive fatigue was associated with lower scores on all domains of the QoL (P ≤ .003), but not for general health domain (P = .010). Similarly, depression was associated with worse QoL on the physical (P = .004) and psychological (P = .001) domains and anxiety with lower scores on the psychological (P < .001) QoL domain. No relationship was found between stroke-specific factors and QoL.
  
  
  CONCLUSIONS
  Fatigue and to a lesser extent depression and anxiety affect the QoL in young adults after ischemic stroke of mild severity. Therefore, young stroke patients should be informed about, screened, and, if possible, treated for fatigue, depression, and anxiety.
authors.affiliation: Department of Neurology, St. Elisabeth Hospital, Tilburg, The Netherlands.
authors.forename: Marienke A A M
authors.initials: MA
authors.lastname: de Bruijn
authors.affiliation: Department of Neurology, St. Elisabeth Hospital, Tilburg, The Netherlands; Department of Neurology, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands. Electronic address: n.synhaeve@elisabeth.nl.
authors.forename: Nathalie E
authors.initials: NE
authors.lastname: Synhaeve
authors.affiliation: Department of Neurology, St. Elisabeth Hospital, Tilburg, The Netherlands; Department of Cognitive Neuropsychology, Center of Research on Psychology in Somatic diseases, Tilburg University, Tilburg, The Netherlands.
authors.forename: Mariëlle W A
authors.initials: MW
authors.lastname: van Rijsbergen
authors.affiliation: Department of Neurology, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
authors.forename: Frank-Erik
authors.initials: FE
authors.lastname: de Leeuw
authors.affiliation: Department of Cognitive Neuropsychology, Center of Research on Psychology in Somatic diseases, Tilburg University, Tilburg, The Netherlands.
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Mark
authors.affiliation: Department of Neurology, St. Elisabeth Hospital, Tilburg, The Netherlands.
authors.forename: Ben P W
authors.initials: BP
authors.lastname: Jansen
authors.affiliation: Department of Neurology, St. Elisabeth Hospital, Tilburg, The Netherlands.
authors.forename: Paul L M
authors.initials: PL
authors.lastname: de Kort
mesh_terms: D000293:Adolescent; D000328:Adult; D002545:Brain Ischemia / Q000150:complications*; D057286:Electronic Health Records / Q000706:statistics & numerical data; D004651:Employment; D005221:Fatigue / Q000209:etiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000209:etiology*; D009426:Netherlands; D011788:Quality of Life / Q000523:psychology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D020521:Stroke / Q000150:complications / Q000209:etiology* / Q000523:psychology*; D055815:Young Adult
keywords: Young stroke; fatigue; prognosis; quality of life