Post-stroke fatigue is associated with impaired processing speed and memory functions in first-ever stroke patients

Objective: Fatigue is a common consequence of stroke that frequently co-occurs with depression. Data on the cognitive associations of post-stroke fatigue (PSF) is scarce. We investigated the relationship of PSF with depressive symptoms and cognitive functioning after stroke. Methods: One hundred and thirty-three working-aged patients with first-ever ischaemic strokes underwent neuropsychological and clinical assessment and evaluation for PSF and depressive symptoms at three months, six months, and two years after stroke. Cognitive domains evaluated included processing speed, memory, executive functions, and reasoning. Fatigue and depressive symptoms were assessed with subscales of the Profile of Mood States. Results: Patients (mean age: 54 +/- 9.5 years, 64.7% male) were divided into groups with (n = 33) and without (n = 100) PSF at three months after stroke. Patients with PSF at three months after stroke had slower processing speed at three months (p = 0.003) and six months (p = 0.013) after stroke and worse memory performance at six months (p = 0.003) after stroke than patients without PSF. Fatigue was also associated with more depressive symptoms. Impairments in processing speed at 3 months and memory at 6 months after stroke persisted after the depressive symptoms were controlled for. PSF was related to a lower rate of returning to work two years after stroke (p = 0.046). Conclusion: PSF at three months after stroke is associated with depressive symptoms and negative cognitive and work-related outcomes following stroke. Deficits in processing speed and memory in patients with PSF were partly observed even after depressive symptoms were controlled for. (C) 2014 Elsevier Inc. All rights reserved.