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The Institute for Global Health and Development

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    Understanding Cognitive Impairment after Stroke: Stories from a Middle-Income Country
    (Springer, 2020-06-11) Hsia Yap, Kwong; Warren, Narelle; Reidpath, Daniel; Allotey, Pascale
    Cognitive impairment (CI) is a common aftermath of stroke and associated with higher stroke burden due to its strong relationship with dementia and functional dependence. However, CI is usually underreported due to the prominence of physical disability represented by stroke. Cross-cultural studies on dementia have also demonstrated that the interpretations of dementia symptoms in different communities resulted in different ways of reporting and management strategies when confronted with symptoms. This study presents findings from a community of Malaysian-Chinese stroke survivors living in Malaysia on their understandings of cognitive deficits after stroke. The way stroke survivors thought about CI was also mediated by the cultural and social context that surrounded them. Of interest was the primacy of physical health over the cognitive which resulted in the invisibility of CI within this community, regardless of whether the deficits were mild or severe. Based on these findings, there is a need to rethink how cognitive decline should be observed in realistic community settings.
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    Fatigue after stroke: Frequency and effect on daily life
    (Taylor & Francis, 2011-10-07) Crosby, Gail A.; Munshi, Sunil; Karat, Aaron S.; Worthington, Esme; Lincoln, Nadina B.
    Purpose: An audit was conducted to assess the frequency of fatigue after stroke, to determine the impact on daily life, and whether it was discussed with clinicians. Method: Patients were recruited from Nottingham University Hospitals NHS Trust stroke service. Patients were interviewed about their fatigue, and the Fatigue Severity Subscale (FSS-FAI), Brief Assessment Schedule for Depression Cards (BASDEC), Barthel Index and Nottingham Extended Activities of Daily Living (EADL) Scale were administered. Results: 64 patients were recruited, with a mean age 73.5 years (SD 14.0, range 37–94 years), 37 (58%) as in-patients and 27 (42%) as outpatients. There were 41 (64%) who reported significant levels of fatigue and 31 (48%) with significant fatigue on the Fatigue Severity Scale. Demographic and clinical variables were not significantly related to fatigue (p > 0.05), apart from gender, with women reporting significantly more fatigue than men (p = 0.006). There was a moderate correlation between the BASDEC and FSS (rs = 0.41, p = 0.002). Of the 41 participants who reported fatigue, 33 (81%) had not discussed this with their clinician. Conclusions: Fatigue was a common problem after stroke. There was a lack of awareness in both patients and clinicians and little advice being given to patients with fatigue.