A Longitudinal View of Apathy and Its Impact After Stroke
A Longitudinal View of Apathy and Its Impact After Stroke
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DOI：
10.1161/strokeaha.109.554410
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发表时间：
2009-10-01
期刊：
影响因子：
8.3
通讯作者：
Wood-Dauphinee, Sharon
中科院分区：
文献类型：
--
作者：
Mayo, Nancy E.;Fellows, Lesley K.;Wood-Dauphinee, Sharon
背景和目的-卒中幸存者通常被描述为冷漠。因为冷漠可能是参与有希望的治疗的障碍，所以需要更多地了解中风后的冷漠症状。具体的目标是估计在何种程度上冷漠的变化与时间超过中风后的第一年，冷漠对recovery. Methods的影响，冷漠评估队列中风幸存者参与纵向研究的健康相关的生活质量中风后形成。一名家庭照顾者在卒中后1、3、6和12个月通过电话完成了冷漠调查问卷（n = 408）。基于组的轨迹建模和有序回归被用来识别独特的群体与相似的轨迹冷漠的个人在中风后的第一年和预测的冷漠trajectors.Results-Both 3和5组轨迹模型拟合的数据。我们使用5组模型，因为有可能进一步探索冷漠结构。最大的一组（50%）有轻度冷漠，33%有轻度冷漠，在中风后的第一年保持稳定。一小部分（3%）的研究样本有高度冷漠，仍然很高。另外两组几乎相同的人数（7%）显示冷漠恶化和改善。认知状态差、功能状态低、合并症多预示着冷漠程度较高。高度冷漠有一个显着的负面影响，身体功能，参与，健康感知，身体健康在第一个12个月后stroke. Conclusion中风后，一定程度的冷漠是普遍和持久的，并预测年龄较大，认知状态差，功能状态低中风后。即使是轻微程度的冷漠对卒中结局也有重要的统计学显著性影响。（中风。2009;40：3299-3307）。
Background and Purpose-Stroke survivors are often described as apathetic. Because apathy may be a barrier to participation in promising therapies, more needs to be learned about apathy symptoms after stroke. The specific objective was to estimate the extent to which apathy changes with time over the first year after stroke and the impact of apathy on recovery.Methods-The Apathy Assessed cohort was formed from stroke survivors participating in a longitudinal study of health-related quality of life after stroke. A family caregiver completed an apathy questionnaire by telephone at 1, 3, 6, and 12 months after stroke (n = 408). Group-based trajectory modeling and ordinal regression were used to identify distinctive groups of individuals with similar trajectories of apathy over the first year after stroke and predictors of apathy trajectory.Results-Both 3- and 5-group trajectory models fit the data. We used the 5-group model because of the potential to further explore the apathy construct. The largest group (50%) had low apathy and 33% had minor apathy that remained stable throughout the first year after stroke. A small proportion (3%) of the study sample had high apathy that remained high. Two other groups of almost equal size (7%) showed worsening and improving apathy. Poor cognitive status, low functional status, and high comorbidity predicted higher apathy. High apathy had a significant negative effect on physical function, participation, health perception, and physical health over the first 12 months after stroke.Conclusion-Some degree of apathy was prevalent and persistent after stroke and was predicted by older age, poor cognitive status, and low functional status after stroke. Even a minor level of apathy had an important and statistically significant impact on stroke outcomes. (Stroke. 2009;40:3299-3307.)