Highlights
- •Subarachnoid haemorrhage impacts cognition and employment status.
- •Reaction time slowing has a discernible impact on employment status.
- •Reaction time and employment can be used as outcomes after subarachnoid haemorrhage in the UK Biobank.
Abstract
Objectives
Survivors of aneurysmal subarachnoid haemorrhage (aSAH) frequently suffer from cognitive
dysfunction. The aim of this study was to assess, in a large sample size with long
term follow-up, the characteristics of cognitive dysfunction following aSAH and explore
whether cognitive deficits mediate employment outcome.
Materials and methods
In this retrospective case-controlled study, aSAH survivors (n = 884) were identified from the UK Biobank and compared to matched controls (n = 3536). Controls were propensity score matched according to age, sex, Townsend deprivation
score, educational status and relevant medications known to influence cognition. Cognitive
outcomes and employment status were compared between cases and controls using group
comparison and cross-tabulation tests. A regression-based mediation analysis was performed
to assess whether cognitive deficits mediate employment status following aSAH.
Results
Psychomotor reaction time and employment status significantly differed between aSAH
cases and controls with slower reaction times (p < 0.001) and more unemployment or inability to work due to illness (p < 0.001) in the aSAH cohort at a mean follow-up of 125 months. Psychomotor slowing
was estimated to mediate a significant proportion (6.59%) of the effect of aSAH on
employment status.
Conclusions
Psychomotor reaction time and employment status differed significantly between aSAH
cases and control matched individuals in the UK Biobank. Psychomotor slowing following
aSAH had a discernible impact on employment status. Psychomotor reaction time and
employment status are practical to acquire and can be used as surrogate measures of
outcome in future studies of aSAH survivors.
Key Words
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Article info
Publication history
Published online: November 10, 2021
Accepted:
October 17,
2021
Received in revised form:
October 5,
2021
Received:
September 2,
2021
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.106184
Copyright
© 2021 Elsevier Inc. All rights reserved.
