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Working status is related to post stroke/TIA cognitive decline: data from the TABASCO study
Hen Hallevi1, Jeremy Molad2, Efrat Kliper2
1Departments of Neurology and Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.
Summary
Pre-stroke unemployment and post-stroke work disruption are linked to worse cognitive function and depression after stroke. Continued employment is crucial for preserving cognitive abilities in stroke survivors.
Area of Science:
- Neuroscience
- Occupational Health
- Psychiatry
Background:
- Occupational status significantly impacts physical and mental recovery following a stroke.
- Understanding the relationship between employment and post-stroke outcomes is critical for patient care.
Purpose of the Study:
- To investigate the association between occupational status and post-stroke outcomes.
- To evaluate the impact of employment on cognitive decline, social engagement, and neuroimaging measures in stroke survivors.
Main Methods:
- A prospective cohort study included 273 first-ever stroke survivors of working age.
- Participants underwent 3T MRI and comprehensive clinical/cognitive assessments at baseline and over 24 months.
- Data analyzed to determine predictors of cognitive decline and return to work.
Main Results:
- Pre-stroke unemployment was linked to diabetes, hypertension, dyslipidemia, depression, poorer cognition, and brain atrophy.
- Returning to work was associated with better cognitive results and fewer depressive symptoms.
- Pre-stroke unemployment independently predicted cognitive decline (HR: 3.0), and mentally stimulating jobs reduced this risk.
Conclusions:
- Pre-stroke unemployment and post-stroke work disruption are associated with depression, poorer cognitive performance, and brain atrophy up to two years post-stroke.
- Retirement post-stroke may elevate the risk of cognitive decline.
- Maintaining employment is vital for preserving cognitive function in stroke survivors.
