Abstract
Objective
Existing literature on white matter hyperintensity volume (WMHV) in stroke patients
has rarely focused on post-stroke outcomes related to social functioning limitations,
such as transportation, social interaction, food preparation, grocery shopping, and
housekeeping. Using prospective data from the VITamin D and OmegA-3 TriaL (VITAL)
study, we evaluated the association between WMHV and social functioning limitations
among 151 ischemic stroke patients.
Materials and methods
WMHV was ascertained from magnetic resonance imaging (MRI) collected at the time of
the stroke event using a validated semiautomated method, and social functioning limitations
were assessed using a stroke outcomes questionnaire administered a median of 1.25
years after the date of the MRI scan. Logistic regression was used to explore the
association between WMHV and social functioning limitations.
Results
After adjusting for age and sex, a statistically significant association was found
between WMHV and limitations in social interaction (OR=2.82; 95% CI: 1.21-7.55). Increased
risks were seen for limitations related to food preparation (OR=2.06; 95% CI: 0.99-4.54),
transportation (OR=1.39; 95% CI: 0.85-2.27), and housekeeping (OR=1.37; 95% CI: 0.91-2.11);
however, the associations did not reach statistical significance. We observed no association
between WMHV and limitations in grocery shopping (OR=1.08; 95% CI: 0.61-1.89).
Conclusions
Future studies are needed to further explore the biological mechanisms underlying
the relationship with limitations in social interaction and to replicate our findings
using a larger and more diverse study sample.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Stroke and Cerebrovascular DiseasesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Poor long-term functional outcome after stroke among adults aged 18 to 50 years: follow-up of transient ischemic attack and stroke patients and unelucidated risk factor evaluation (FUTURE) study.Stroke. 2014; 45: 1157-1160https://doi.org/10.1161/STROKEAHA.113.004411
- Deterioration of gait and balance over time: the effects of age-related white matter change–the LADIS study.Cerebrovasc Dis. 2013; 35: 544-553https://doi.org/10.1159/000350725
- White matter hyperintensities, cognitive impairment and dementia: an update.Nat Rev Neurol. 2015; 11: 157-165https://doi.org/10.1038/nrneurol.2015.10
- Participation in complex and social everyday activities six years after stroke: predictors for return to pre-stroke level.PLoS One. 2015; 10e0144344https://doi.org/10.1371/journal.pone.0144344
- Community re-integration and long-term need in the first five years after stroke: results from a national survey.Disabil Rehabil. 2015; 37: 1834-1838https://doi.org/10.3109/09638288.2014.981302
- The VITamin D and OmegA-3 TriaL (VITAL): rationale and design of a large randomized controlled trial of vitamin D and marine omega-3 fatty acid supplements for the primary prevention of cancer and cardiovascular disease.Contemp Clin Trials. 2012; 33: 159-171https://doi.org/10.1016/j.cct.2011.09.009
- Classification of subtype of acute ischemic stroke.Stroke. 1993; 24: 35-41https://doi.org/10.1161/01.str.24.1.35
- Association of homocysteine with plasma amyloid beta protein in aging and neurodegenerative disease.Neurology. 2005; 65: 1402-1408https://doi.org/10.1212/01.wnl.0000183063.99107.5c
- Determinants of white matter hyperintensity volume in patients with acute ischemic stroke.J Stroke Cerebrovasc Dis. 2010; 19: 230-235https://doi.org/10.1016/j.jstrokecerebrovasdis.2009.05.007
- White matter hyperintensity volume is increased in small vessel stroke subtypes.Neurology. 2010; 75: 1670-1677https://doi.org/10.1212/WNL.0b013e3181fc279a
- Setting a gold standard for quantification of leukoaraiosis burden in patients with ischemic stroke: the atherosclerosis risk in communities study.J Neurosci Methods. 2014; 221: 196-201https://doi.org/10.1016/j.jneumeth.2013.10.009
- Intracranial area: a validated method for estimating intracranial volume.J Neuroimag. 2005; 15: 76-78https://doi.org/10.1177/1051228404270243
- Validation of intracranial area as a surrogate measure of intracranial volume when using clinical MRI.J Neuroimaging. 2007; 17: 74-77https://doi.org/10.1111/j.1552-6569.2006.00069.x
- The framingham disability study: I. Social disability among the aging.Am J Public Health. 1981; 71: 1202-1210
- WMH and long-term outcomes in ischemic stroke: a systematic review and meta-analysis.Neurology. 2019; 92: e1298-e1308https://doi.org/10.1212/WNL.0000000000007142
- Severe lesions involving cortical cholinergic pathways predict poorer functional outcome in acute ischemic stroke.Stroke. 2018; 49: 2983-2989https://doi.org/10.1161/STROKEAHA.118.023196
- Functional recovery and instrumental activities of daily living: follow-up 1-year after treatment in a stroke unit.Brain Inj. 2002; 16: 207-216https://doi.org/10.1080/02699050110103337
- White matter hyperintensity in elderly patients with diabetes mellitus is associated with cognitive impairment, functional disability, and a high Glycoalbumin/Glycohemoglobin RATIO.Front Aging Neurosci. 2017; 9: 220https://doi.org/10.3389/fnagi.2017.00220
- Impact of frontal white matter hyperintensity on instrumental activities of daily living in elderly women with Alzheimer disease and amnestic mild cognitive impairment.PLoS One. 2017; 12e0172484https://doi.org/10.1371/journal.pone.0172484
- Subcortical white matter lesions and functional impairment in geriatric depression.Depress Anxiety. 2002; 15: 23-28https://doi.org/10.1002/da.1081
- Residual disability in survivors of stroke–the Framingham study.N Engl J Med. 1975; 293: 954-956https://doi.org/10.1056/NEJM197511062931903
- How does cognition shape social relationships?.Philos Trans R Soc B. 2018; 37320170293https://doi.org/10.1098/rstb.2017.0293
- Functional cooking skills and neuropsychological functioning in patients with stroke: an ecological validity study.Neuropsychol Rehabil. 2010; 20: 725-738https://doi.org/10.1080/09602011003765690
Article info
Publication history
Published online: September 01, 2022
Accepted:
August 13,
2022
Received in revised form:
August 10,
2022
Received:
May 12,
2022
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106720
Copyright
© 2022 Elsevier Inc. All rights reserved.
