The Neuropsychological and Functional Outcomes of Primary Intracerebral Haemorrhage (ICH) at 6 and 12 Month Follow Up: A Population-Based Study

Abstract

This exploratory population-based study examined the short-term (6-month) and long-term (12-month) mood, cognitive, and functional outcomes of Intracerebral Haemorrhage (ICH). Previous research has tended to use hospital-based samples; examine stroke outcomes generally rather than specific to stroke subtype; assess outcomes only in the acute phase post-stroke; and favour functional outcomes, while neglecting neuropsychological outcomes. The aims of the current study, therefore, were: to compare 6- and 12-month outcomes of ICH survivors to matched controls; to describe the natural course of recovery of mood, cognitive, and functional outcomes over the first year post-ICH; to examine the interrelationships between mood, cognitive, and functional outcomes of ICH; and to determine if there are characteristics of the ICH survivor at baseline that predicts good versus poor functional and cognitive outcomes at 12 months. The study used a sample of 35 ICH survivors drawn from the Auckland Regional Community Stroke (ARCOS) IV Study and 34 healthy controls matched for age, gender, and ethnicity who were recruited from the Auckland community. Both the ICH group and the control group were administered a series of measures assessing their mood, cognition, and functioning (independence in activities of daily living [ADLs] and health related quality of life [HRQoL]). The ICH group were assessed, where possible, at three timeframes: baseline (within 2 weeks of ICH), 6 months post-ICH, and 12 months post-ICH. The results indicate that cognitive impairment following ICH is common, widespread, and persisting. Mood difficulties, particularly mild depression, were also present for ICH survivors over the study period. The ICH group had significantly less independence in ADLs, although improvement over the 12 months was observed. There were mixed findings when it came to HRQoL. Physical HRQoL post-ICH was impaired but not necessarily mental HRQoL. Younger age was found to correlate with poorer mood outcomes. Given the exploratory nature of the study, and limited power due to a small sample size, the findings are not considered conclusive. However, the results highlight the need for a greater focus on cognition and mood in rehabilitation of ICH survivors and on future research in these areas.