Post-stroke fatigue: The role of comorbidities and its impact on quality of life

Abstract

Background: Post-stroke fatigue (PSF) is a common complication following stroke that affects approximately 50% of stroke survivors.

Purpose: The purpose of this study was to investigate the role of comorbidities in PSF and the impact of PSF on Quality of Life (QoL). To achieve this, residual stroke symptoms have also been considered.

Methods: The participants were stroke survivors living in a Swedish municipality. Self-reported data were collected via the Fatigue Assessment Scale (FAS), the Riksstroke questionnaire, and the Short Form Health Survey 36 (SF-36). Linear multiple regression and Spearman's correlation coefficient were used to analyze the data.

Results: A total of 142 participants (83 men) with a mean age of 74.8 (SD 9.7) years were included in the study. Fatigue levels were classified as normal (FAS 10-21) for 70 (49.3%) individuals, mild-to-moderate (FAS 22-34) for 56 (39.4%) individuals, and severe (FAS 35-50) for 16 (11.3%) individuals. The mean FAS score was 23.3 (SD 8.2). Multiple regression analysis indicated that the presence of vertigo (β = 0.24, p = 0.004), chronic pulmonary disorders (β = 0.29, p = 0.003), and hemiparesis (β = 0.18, p = 0.05) were associated with more severe PSF. The model explained 19.2% of the variance in PSF. A higher level of PSF was associated with worse QoL in all eight SF-36 domains (r = -0.38 to -0.67).

Conclusions: Vertigo, chronic pulmonary disorders, and hemiparesis were significantly associated with more severe PSF. Additionally, higher levels of fatigue were associated with a worse QoL. These findings confirm that PSF is a multifaceted phenomenon, underscoring the importance of addressing PSF in rehabilitation to improve outcomes for stroke survivors.

Keywords: Comorbidity; Post-stroke fatigue; Quality of life; Social factors; Stroke.