Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 May 9;2(3):e000458.
doi: 10.1136/bmjopen-2011-000458. Print 2012.

The relationship between executive dysfunction and post-stroke mortality: a population-based cohort study

Bernice Wiberg  1 , Lena Kilander, Johan Sundström, Liisa Byberg, Lars Lind
Affiliations

The relationship between executive dysfunction and post-stroke mortality: a population-based cohort study

Bernice Wiberg et al. BMJ Open. .

Abstract

Objectives: To study the associations of pre-stroke cognitive performance with mortality after first-ever stroke or transient ischaemic attack (TIA).

Design: A prospective cohort study.

Setting and participants: In participants having first-ever stroke or TIA during up to 14 years of post-test follow-up (n=155), we investigated the associations of pre-stroke variables and cognitive test results with post-stroke survival. The study is based on those participants of the Uppsala Longitudinal Study of Adult Men who performed cognitive function tests at approximately age 70 (n=919).

Primary outcome measures: Mortality after first-ever stroke or TIA related to pre-stroke executive performance.

Results: Eighty-four (54%) of the first-ever stroke/TIA patients died under a median follow-up of 2.5 years after the event. In Cox proportional hazard analyses adjusting for age, education, social group and traditional stroke risk factors, poor performance in Trail Making Test (TMT)-A was related to mortality (HR 1.88 per SD, 95% CI 1.31 to 2.71, p=0.001). The risk of mortality was approximately threefold higher in the highest tertile compared with the lowest tertile (HR TMT-A= 2.90 per SD, 95% CI 1.24 to 6.77, p=0.014). A similar pattern was seen for TMT-B, but Mini-Mental State Examination results were not related to risk of post-stroke mortality.

Conclusion: Executive performance measured by TMT-A and -B before stroke was independently associated with long-term risk of mortality, after first-ever stroke or TIA in a population-based study of older men.

PubMed Disclaimer

Conflict of interest statement

Competing interests: BW, LK and LB report no disclosures. JS serves on a scientific advisory board for Itrim. LL receives research support from AstraZeneca.

Figures

Figure 1
Figure 1
Kaplan–Meier survival estimates for Trail Making Test A in tertiles.
Figure 2
Figure 2
Kaplan–Meier survival estimates for Trail Making Test B in tertiles.
See this image and copyright information in PMC

References

    1. Stegmayr B, Asplund K. Exploring the declining case fatality in acute stroke. Population-based observations in the northern Sweden MONICA Project. J Intern Med 1996;240:143–9 - PubMed
    1. Counsell C, Dennis M. Systematic review of prognostic models in patients with acute stroke. Cerebrovasc Dis 2001;12:159–70 - PubMed
    1. Appelros P, Nydevik I, Seiger A, et al. Predictors of severe stroke: influence of preexisting dementia and cardiac disorders. Stroke 2002;33:2357–62 - PubMed
    1. Appelros P, Nydevik I, Viitanen M. Poor outcome after first-ever stroke: predictors for death, dependency, and recurrent stroke within the first year. Stroke 2003;34:122–6 - PubMed
    1. Wiberg B, Lind L, Kilander L, et al. Cognitive function and risk of stroke in elderly men. Neurology 2010;74:379–85 - PubMed

LinkOut - more resources