Saami Zakaria1, Hamza Ahmed1, Kara Melmed1, Benjamin Brush1, Aaron Lord1, Lindsey Gurin1, Jennifer Frontera1, Koto Ishida1, Jose Torres1, Cen Zhang1, Leah Dickstein1, David Kahn1, Ting Zhou1, Ariane Lewis1
1Neurology, NYU Langone Medical Center
Objective:
The objective of this study was to determine the relationship between cognitive, psychiatric, and functional outcomes 3 months after hemorrhagic stroke.
Background:
Hemorrhagic stroke may cause cognitive limitations. Studying the association between cognition, psychiatric outcomes, and functional status after hemorrhagic stroke may improve understanding of cognition in this patient population.
Design/Methods:
Patients with non-traumatic intracerebral or subarachnoid hemorrhage (ICH or SAH) admitted at an urban academic medical center between January 2015 and January 2024 were assessed by telephone 3 months after discharge using the Quality of Life in Neurological Disorders (Neuro-QoL) Cognitive Function, Anxiety, Depression, and Sleep Disturbance short forms, as well as the modified Rankin Scale (mRS). Univariate and multivariate analysis were used to evaluate the relationship between poor cognition (Neuro-QoL t-score ≤ 50) and functional status and psychiatric comorbidities in 1) patients with ICH or SAH and 2) patients with ICH.
Results:
Of 101 patients (62 ICH and 39 SAH), there were 51 (50%) with poor cognition 3-months post-bleed, 60 (61%) with mRS score 3-5, 43 (43%) with anxiety, 28 (28%) with depression, and 30 (31%) with sleep disturbance. On univariate analysis of the full cohort, poor cognition was associated with (p<0.05) anxiety, depression, sleep disturbance, and mRS score 3-5. On multivariate analysis, poor cognition was associated with anxiety (OR 4.38, 95% CI 1.3-14.7, p = 0.017) and mRS score 3-5 (OR 6.15, 95% CI 1.96-19.3, p = 0.002). On univariate analysis of the 62 patients with ICH, poor cognition was associated with (p<0.05) anxiety, sleep disturbance, and mRS score 3-5. On multivariate analysis, poor cognition was associated with anxiety (OR 10.98, 95% CI 2.3-52, p = 0.003).
Conclusions:
Poor cognition is associated with anxiety 3 months after hemorrhagic stroke. Additional research is needed to understand whether treatment of anxiety would improve cognition in this patient population.
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