Fatigue in men and women 3 and 12 months after ischemic stroke: Occurrence, severity, impact on functioning, and changes over time

BACKGROUND: Although fatigue is common after stroke, there is limited knowledge about gender-specific differences, fatigue severity, impact on functioning, and how fatigue changes over time. With advanced stroke treatments and a higher proportion of mild strokes, updated knowledge about this condition is important. OBJECTIVE: To investigate the occurrence, severity, and impact of fatigue among men and women at 3 and 12 months after first-ever ischemic stroke, including changes over time and differences between the genders. DESIGN: Prospective observational design. SETTING: University hospital setting. PARTICIPANTS: A total of 268 persons (91 women) with first ever ischemic stroke (median age 73 years). MAIN OUTCOME MEASURE: The 10-item Swedish version of the Fatigue Assessment Scale (S-FAS) with scores ranging from 10 to 50; higher scores indicating more fatigue. RESULTS: Significantly more women than men reported fatigue (ie, S-FAS scores ≥24) at 3 months (46% vs. 30%; p = .013) and 12 months (42% vs. 28%; p = .036). Moderate fatigue (S-FAS scores 24-35) was most common in both genders and at both time points. Fatigue had a similar negative impact on functioning in both men and women; the most frequent reported problems were being troubled by fatigue, getting tired very quickly, and doing few things during the day. Overall, total S-FAS scores decreased significantly between 3 and 12 months among both men (median 31 vs. 27, p = .037) and women (median 30 vs. 27, p = .007), although individual variations occurred. CONCLUSION: Fatigue was common among people with first-ever ischemic stroke, particularly in women. Although fatigue decreased over the first year, both men and women struggled with persistent fatigue which impacted their functioning negatively. To provide person-centered interventions and reduce the burden of fatigue after stroke, clinicians should reassess not only the occurrence of fatigue but also its severity and consequences over time.