Fatigue Following Pediatric Arterial Ischemic Stroke: Prevalence and Associated Factors

Background and Purpose: The aims of this study were to assess the prevalence of multidimensional fatigue symptoms 5 years after pediatric arterial ischemic stroke and identify factors associated with fatigue. Methods: Thirty-one children (19 males) with pediatric arterial ischemic stroke, participating in a larger prospective, longitudinal study, were recruited to this study at 5 years poststroke. Parent- and self-rated PedsQL Multidimensional Fatigue Scale scores were compared with published normative data. Associations between parent-rated PedsQL Multidimensional Fatigue Scale, demographics, stroke characteristics, and concurrent outcomes were examined. Results: Parent-rated total, general and cognitive fatigue were significantly poorer than population norms, with more than half of all parents reporting fatigue symptoms in their children. One-third of children also reported experiencing fatigue symptoms, but their ratings did not differ significantly from normative expectations, as such, all further analyses were on parent ratings of fatigue. Older age at stroke and larger lesion size predicted greater general fatigue; older age, female sex, and higher social risk predicted more sleep/rest fatigue. No significant predictors of cognitive fatigue were identified and only older age at stroke predicted total fatigue. Greater fatigue was associated with poorer adaptive functioning, motor skills, participation, quality of life, and behavior problems but not attention. Conclusions: Fatigue is a common problem following pediatric arterial ischemic stroke and is associated with the functional difficulties often seen in this population. This study highlights the importance of long-term monitoring following pediatric arterial ischemic stroke and the need for effective interventions to treat fatigue in children.

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Age groups changes in self-rated health: A prospective longitudinal study over a 20-year period using Health Survey of North Trøndelag data

Scandinavian Journal of Public Health ◽

10.1177/1403494820904626 ◽

2020 ◽

pp. 140349482090462

Author(s):

Frode Lysberg ◽

Siw Tone Innstrand ◽

Milada Cvancarova Småstuen ◽

Cathrine Lysberg ◽

Magnhild Mjåvatn Høie ◽

...

Keyword(s):

Sex Differences ◽

Health Survey ◽

Age Groups ◽

Older Age ◽

Age Group ◽

Middle Aged ◽

Prospective Longitudinal Study ◽

Future Studies ◽

Self Rated Health ◽

Prospective Longitudinal

Background: The aim of the study was to investigate changes in self-rated health (SRH) between different age groups and sexes over a 20-year period. Methods: Data were retrieved from the large longitudinal Health Survey of North Trøndelag, Norway, which includes data collected from more than 190,000 participants aged 20–70+ years between the years 1984 and 2008. Data were analysed using logistic regression and adjusted for sex. Results: From 1984 to 2008, the odds of scoring higher on SRH decreased by 46% in the youngest age group (20–29 years) and increased by approximately 35% in the middle-aged and older age groups (40–70+ years). When considering sex differences, women in most age groups scored lower than the men on their SRH. Conclusions: Our finding suggest a trending shift in SRH, with a reduction in the youngest age group (20–29 years) and an increase in the middle-aged and older age groups (40–70+ years). Despite the sex differences being small, our data indicate that in most age groups, women tend to score lower than men on their SRH. Future studies should focus on these trends to understand better the mechanisms underlying these changes in SRH and to follow future trends to see if the trend is reinforced or diminished.

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Impact of Age at Pediatric Stroke on Long-term Cognitive Outcome

Neurology ◽

10.1212/wnl.0000000000013207 ◽

2021 ◽

pp. 10.1212/WNL.0000000000013207

Author(s):

Stephanie Abgottspon ◽

Qendresa Thaqi ◽

Leonie Steiner ◽

Nedelina Slavova ◽

Sebastian Grunt ◽

...

Keyword(s):

Early Childhood ◽

Ischemic Stroke ◽

Processing Speed ◽

Lesion Size ◽

Cognitive Outcome ◽

Late Childhood ◽

Control Group ◽

Childhood Stroke ◽

Arterial Ischemic Stroke

Objectives:To investigate the impact of age at pediatric arterial ischemic stroke on long-term cognitive outcome in order to identify patients particularly at risk for the development of cognitive long-term cognitive sequelae.Methods:This cross-sectional study included patients in the chronic phase of stroke (> 2 years after stroke) previously diagnosed with neonatal or childhood arterial ischemic stroke and a control group. Participants with active epilepsy, severe learning difficulties, or behavioral problems hindering the cognitive assessment were excluded. Several cognitive domains, including intelligence, executive functions (working memory, inhibition, and cognitive flexibility), processing speed, memory, letter fluency, and visual-motor skills were assessed with neuropsychological tests. Cognitive long-term outcome was compared across patients after neonatal stroke (stroke between 0 and 28 days of life), early childhood stroke (stroke between 29 days and < 6 years) and late childhood stroke (stroke between ≥ 6 and < 16 years).Results:52 patients after neonatal or childhood arterial ischemic stroke (median age: 15.3 years, IQR = 10.6 – 18.7) and 49 healthy controls (median age: 13.6 years, IQR = 9.8 – 17.2) met the inclusion criteria. Cognitive outcome was significantly worse in the pediatric stroke group compared to the control group. A non-linear effect of age at stroke (irrespective of lesion size and lesion location) was found for cognitive flexibility, processing speed, and verbal learning with early childhood stroke (29 days to < 6 years) showing significantly worse cognitive outcome compared to neonatal or late childhood stroke (p < .05, FDR-corrected).Conclusion:Age at stroke is an important factor for post-stroke recovery and modulates long-term cognitive outcome irrespective of lesion size and lesion location. Children after early childhood stroke are at particular risk for alterations of long-term cognitive functions.

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Urban Young Adults’ Adaptive Functioning

Journal of Drug Issues ◽

10.1177/0022042616684679 ◽

2016 ◽

Vol 47 (2) ◽

pp. 261-276 ◽

Cited By ~ 2

Author(s):

Leah S. Forman ◽

Jane M. Liebschutz ◽

Ruth Rose-Jacobs ◽

Mark A. Richardson ◽

Howard J. Cabral ◽

...

Keyword(s):

Young Adults ◽

Adolescent Pregnancy ◽

Adaptive Functioning ◽

Alcohol Exposure ◽

Self Report ◽

Tobacco Exposure ◽

Prospective Longitudinal Study ◽

Prenatal Cocaine ◽

Prospective Longitudinal

Research on the association between prenatal substance exposures and adaptive functioning among young adults is limited, with inconsistent conclusions. In a prospective longitudinal study of 138 urban young adults, prenatal substance exposures were identified at birth from maternal self-report, urine screens, and/or infant meconium. At follow-up between ages 18 and 24 years, masked interviewers assessed level of adaptive functioning, a composite indicator comprising five domains: education, housing, adolescent pregnancy, arrest history, and employment. A significant negative association was found between prenatal tobacco exposure and adaptive functioning, particularly among females with heavier exposure. This association with heavier, but not lighter, prenatal tobacco exposure is consistent with a neuroteratologic explanation, but other, non-biological explanations cannot be ruled out. No statistically significant associations were observed between prenatal cocaine, marijuana, or low-moderate alcohol exposure and young adult adaptive functioning.

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Endovascular Thrombectomy for Pediatric Acute Ischemic Stroke: A Multi-Institutional Experience of Technical and Clinical Outcomes

Neurosurgery ◽

10.1093/neuros/nyaa312 ◽

2020 ◽

Vol 88 (1) ◽

pp. 46-54

Author(s):

Vijay M Ravindra ◽

Matthew Alexander ◽

Philipp Taussky ◽

Robert J Bollo ◽

Ameer E Hassan ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Clinical Outcomes ◽

Pediatric Patients ◽

Tertiary Care ◽

Prospective Longitudinal Study ◽

Endovascular Thrombectomy ◽

Technical Data ◽

Prospective Longitudinal

Abstract BACKGROUND Endovascular thrombectomy is a promising treatment for acute ischemic stroke in children, but outcome and technical data in pediatric patients with large-vessel occlusions are lacking. OBJECTIVE To assess technical and clinical outcomes of thrombectomy in pediatric patients. METHODS We undertook a retrospective cohort study of pediatric patients who experienced acute ischemic stroke from April 2017 to April 2019 who had immediate, 30-, and 90-d follow-up. Patients were treated with endovascular thrombectomy at 5 US pediatric tertiary care facilities. We recorded initial and postprocedural modified Thrombolysis in Cerebral Infarction (mTICI) grade ≥ 2b, initial and postprocedural Pediatric National Institutes of Health Stroke Scale (PedNIHSS) score, and pediatric modified Rankin scale (mRS) score 0 to 2 at 90 d. RESULTS There were 23 thrombectomies in 21 patients (mean age 11.6 ± 4.9 yr, median 11.5, range 2.1-19; 52% female). A total of 19 (83%) thrombectomies resulted in mTICI grade ≥ 2b recanalization. The median PedNIHSS score was 13 on presentation (range 4-33) and 2 (range 0-26) at discharge (mean reduction 11.3 ± 6.1). A total of 14 (66%) patients had a mRS score of 0 to 2 at 30-d follow-up; 18/21 (86%) achieved that by 90 d. The median mRS was 1 (range 0-4) at 30 d and 1 (range 0-5) at 90 d. One patient required a blood transfusion after thrombectomy. CONCLUSION In this large series of pediatric patients treated with endovascular thrombectomy, successful recanalization was accomplished via a variety of approaches with excellent clinical outcomes; further prospective longitudinal study is needed.

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Old Age and Loneliness: Cross-sectional and Longitudinal Analyses in the Tampere Longitudinal Study on Aging

Canadian Journal on Aging / La Revue canadienne du vieillissement ◽

10.1353/cja.2004.0023 ◽

2004 ◽

Vol 23 (2) ◽

pp. 157-168 ◽

Cited By ~ 127

Author(s):

Marja Jylhä

Keyword(s):

Longitudinal Study ◽

Age Groups ◽

Population Based ◽

Household Composition ◽

Older Age ◽

Cross Sectional ◽

Prospective Longitudinal Study ◽

Sectional Analysis ◽

Prospective Longitudinal

ABSTRACTThe purpose of this study was to examine whether older age is associated with increasing loneliness in people aged 60 and over. Data came from TamELSA, a population-based prospective longitudinal study in Tampere, Finland. The follow-up time was 20 years. Loneliness was measured by a single question – “Do you feel lonely?“ – with the possible answers often, sometimes, or never. Cross-sectional analysis showed that the percentage of subjects feeling lonely increased toward older age groups, but in a multivariate analysis, only household composition and social participation were independently associated with loneliness. Longitudinal analysis showed that loneliness increased with higher age. Over a 10-year period, loneliness increased most in those who, at baseline, were married and living alone with their spouse. In conclusion, only a minority of older people continuously suffer from loneliness. Loneliness does increase with age, not because of age per se, but because of increasing disability and decreasing social integration.

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Early Rehabilitation in Acute Care Inpatient Wards May Be Crucial to Functional Recovery 3 Months After Ischemic Stroke

Physical Therapy ◽

10.1093/ptj/pzaa197 ◽

2020 ◽

Vol 101 (1) ◽

Author(s):

Ching-Yi Wang ◽

Yueh-Chi Chen ◽

Chun-Hou Wang

Keyword(s):

Ischemic Stroke ◽

Acute Stroke ◽

Acute Care ◽

Functional Recovery ◽

Barthel Index ◽

Functional Change ◽

Early Rehabilitation ◽

Prospective Longitudinal Study ◽

Inpatient Ward ◽

Prospective Longitudinal

Abstract Objective Early rehabilitation in acute care inpatient wards may maximize functional outcome at 3 months after stroke in survivors of stroke. It is unknown whether functional change during acute care hospitalization is significantly associated with functional recovery at 3 months in survivors of acute stroke. The purposes of this study were to examine the association of the Barthel Index (BI) at 3 months with functional change as measured with the Barthel Index (ΔBI) in an acute care inpatient ward and to identify the factors associated with ΔBI and who could benefit from an early rehabilitation program. Methods In this prospective longitudinal study, 76 patients with ischemic stroke in an acute care inpatient ward received early rehabilitation of up to 2 sessions per day for 5 d/wk during their stay. Therapy density was calculated as the proportion of total therapy sessions completed. At admission and discharge, they were assessed with the BI and the Postural Assessment Scale for Stroke Patients (PASS). Demographic and health-related information was also collected. The Barthel Index (BI) was reassessed at 3 months. Results ΔBI in the acute care inpatient ward significantly predicted the BI at 3 months, over and above the other significant variables; in addition, therapy density and change in PASS were significantly associated with ΔBI. Patients with moderate initial functional dependence had the largest ΔBI, followed by the group with a more severe condition. Conclusions ΔBI in acute care inpatient wards may be an important predictor of the BI at 3 months. Therapy density and change in PASS were significantly associated with ΔBI. Impact Survivors of acute stroke who receive up to 2 rehabilitation sessions per day for 5 d/wk early in their hospitalization have better functional recovery at 3 months after stroke.

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Has life satisfaction in Norway increased over a 20-year period? Exploring age and gender differences in a prospective longitudinal study, HUNT

Scandinavian Journal of Public Health ◽

10.1177/1403494817744650 ◽

2017 ◽

Vol 46 (1) ◽

pp. 132-140 ◽

Cited By ~ 4

Author(s):

Frode Lysberg ◽

PåL Gjerstad ◽

Milada Cvancarova Småstuen ◽

Siw Tone Innstrand ◽

Magnhild Mjåvatn Høie ◽

...

Keyword(s):

Life Satisfaction ◽

Age Groups ◽

Older Age ◽

Health Study ◽

Prospective Longitudinal Study ◽

Younger Age ◽

Age And Gender Differences ◽

And Gender ◽

Prospective Longitudinal ◽

Overall Life Satisfaction

Aim: The aim of the present study was to investigate the change in overall life satisfaction for different age groups and between genders over a 20-year period. Methods: Data from 1984 to 2008 were extracted from a large prospective longitudinal health study of Nord-Trøndelag (HUNT), Norway. The study included more than 176,000 participants ranging from 20 to 70+ years of age. Data were analysed using logistic regression and adjusted for gender. Results: The analyses revealed an increase in life satisfaction for all age groups from 1984–1986 (HUNT 1) to 1995–1997 (HUNT 2), with the highest levels being reached at 2006–2008 (HUNT 3). For all age groups, the data showed an increase of about 20% for the period from 1984–1986 (HUNT 1) to 1995–1997 (HUNT 2). From 1995–1997 (HUNT 2) to 2006–2008 (HUNT 3), the increase in overall life satisfaction was 16% for the younger age groups, and about 32% for the older age groups (40–69 and 70+ years). Women’s scores for overall life satisfaction were higher for nearly all age groups when compared to men using HUNT 3 as a reference. Conclusions: These findings suggest an increase in life satisfaction for all age groups from 1984 to 2008, especially for the older age group (40–69 and 70+ years). The data indicate that women score higher on life satisfaction for most age groups as compared to men.

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