Cognitive performance is associated with return to work after ischemic stroke in young adults: The ODYSSEY study
European Stroke Journal, vol. 10, pp. 784–795
Abstract
Abstract Introduction Limited data exist on cognitive performance and return to work after ischemic stroke, especially in patients under 50 years. We investigated whether cognitive performance in the subacute phase after ischemic stroke in young adults was associated with unemployment and the inability to retain their jobs among those who returned to work. Patients and methods We conducted a multicenter prospective cohort study between 2013 and 2021, enrolling patients aged 18–49 years with first-ever ischemic stroke. Cognitive assessments were performed within 6 months following the index event, covering seven cognitive domains. We categorized patients with cognitive impairment (Z-score < −1.5 on a domain) and as no/mild or major vascular cognitive disorder (VCD; Z-score < −2.0 in one or more domains). Cognitive performance and other predefined characteristics were chosen to identify factors associated with unemployment and, among patients who returned to work, the inability to maintain employment. Results Of 525 patients (median age 44.3 [IQR 38.0–47.4] years; 243 women [46.3%]); median follow-up of 6.6 [IQR 4.5–8.2] years), 426 patients (81.1%) returned to work. Sixty-five patients (15.3%) were unable to maintain employment. In multivariable logistic regression analysis, major VCD (OR = 2.0; 95% CI 1.3–3.0; p = 0.002) and cognitive impairment in processing speed (OR = 2.0; 95% CI 1.3–3.3; p = 0.004) were associated with unemployment, but not with the inability to maintain employment. Discussion and conclusion In young patients after a first-ever ischemic stroke, major VCD and impaired processing speed in the subacute phase after stroke were independently associated with unemployment, but not with the inability to maintain employment.
Authors 28
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Radboud University Nijmegen · Radboud University Medical Center · Donders Institute for Brain, Cognition and Behaviour
Affiliation as printed
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands 1
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
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Radboud University Nijmegen · Radboud University Medical Center · Donders Institute for Brain, Cognition and Behaviour
Affiliation as printed
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands 1
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
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Radboud University Nijmegen · Radboud University Medical Center · Donders Institute for Brain, Cognition and Behaviour
Affiliation as printed
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands 1
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
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Radboud University Nijmegen · Radboud University Medical Center · Donders Institute for Brain, Cognition and Behaviour
Affiliation as printed
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands 1
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
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Radboud University Nijmegen · Radboud University Medical Center · Donders Institute for Brain, Cognition and Behaviour
Affiliation as printed
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands 1
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
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Radboud University Nijmegen · Radboud University Medical Center · Donders Institute for Brain, Cognition and Behaviour
Affiliation as printed
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands 1
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
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Radboud University Nijmegen · Radboud University Medical Center · Donders Institute for Brain, Cognition and Behaviour
Affiliation as printed
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands 1
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
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Affiliation as printed
Department of Neurology, Gelre Hospitals, Apeldoorn, The Netherlands 2
Department of Neurology, Gelre Hospitals, Apeldoorn, The Netherlands
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Affiliation as printed
Department of Neurology, Medisch Spectrum Twente, Enschede, The Netherlands 3
Department of Neurology, Medisch Spectrum Twente, Enschede, The Netherlands
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Affiliation as printed
Department of Neurology, Medisch Spectrum Twente, Enschede, The Netherlands 3
Department of Neurology, Medisch Spectrum Twente, Enschede, The Netherlands
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Canisius-Wilhelmina Ziekenhuis
Affiliation as printed
Department of Neurology, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands 4
Department of Neurology, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
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Affiliation as printed
Department of Neurology, Catharina Hospital, Eindhoven, The Netherlands 5
Department of Neurology, Catharina Hospital, Eindhoven, The Netherlands
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Affiliation as printed
Department of Neurology, Catharina Hospital, Eindhoven, The Netherlands 5
Department of Neurology, Catharina Hospital, Eindhoven, The Netherlands
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Affiliation as printed
Department of Neurology, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands 6
Department of Neurology, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
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Elisabeth-TweeSteden Ziekenhuis
Affiliation as printed
Department of Neurology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands 7
Department of Neurology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
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Affiliation as printed
Department of Neurology, Haga Hospital, Den Haag, The Netherlands 8
Department of Neurology, Haga Hospital, Den Haag, The Netherlands
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Affiliation as printed
Department of Neurology, Amphia Hospital, Breda, The Netherlands 9
Department of Neurology, Amphia Hospital, Breda, The Netherlands
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Affiliation as printed
Department of Neurology, Rijnstate Hospital, Arnhem, The Netherlands 10
Department of Neurology, Rijnstate Hospital, Arnhem, The Netherlands
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Affiliation as printed
Department of Neurology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands 11
Department of Neurology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
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Maastricht University Medical Centre
Affiliation as printed
Department of Neurology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Centre, Maastricht, The Netherlands 12
Department of Neurology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Centre, Maastricht, The Netherlands
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Leiden University · University Medical Center Groningen · Leiden University Medical Center
Affiliation as printed
Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands 13
Department of Neurology, University Medical Centre Groningen, Groningen, The Netherlands 14
Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
Department of Neurology, University Medical Centre Groningen, Groningen, The Netherlands
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Amsterdam University Medical Centers
Affiliation as printed
Department of Neurology, Amsterdam University Medical Centre, Amsterdam, The Netherlands 15
Department of Neurology, Amsterdam University Medical Centre, Amsterdam, The Netherlands
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Affiliation as printed
Department of Neurology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands 16
Department of Neurology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
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Medisch Centrum Haaglanden · Stichting Haaglanden Medisch Centrum
Affiliation as printed
Department of Neurology, Haaglanden Medical Center, Den Haag, The Netherlands 17
Department of Neurology, Haaglanden Medical Center, Den Haag, The Netherlands
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Elisabeth-TweeSteden Ziekenhuis
Affiliation as printed
Department of Neurology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands 7
Department of Neurology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
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Radboud University Nijmegen · Radboud University Medical Center · Donders Institute for Brain, Cognition and Behaviour
Affiliation as printed
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands 1
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
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Radboud University Nijmegen · Radboud University Medical Center · Donders Institute for Brain, Cognition and Behaviour · Donders Centre for Cognition
Affiliation as printed
Department of Medical Psychology and Radboudumc Alzheimer Centre, Radboud University Medical Centre, Nijmegen, The Netherlands 20
Donders Institute for Brain, Cognition and Behaviour, Center for Cognition, Radboud University, Nijmegen, The Netherlands 18
Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands 19
Department of Medical Psychology and Radboudumc Alzheimer Centre, Radboud University Medical Centre, Nijmegen, The Netherlands
Donders Institute for Brain, Cognition and Behaviour, Center for Cognition, Radboud University, Nijmegen, The Netherlands
Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
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Anil M. Tuladhar corresponding
Radboud University Nijmegen · Radboud University Medical Center · Donders Institute for Brain, Cognition and Behaviour
Affiliation as printed
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands 1
Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
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