Abstract WMP31: Lifetime Trauma Exposure Types Are Linked to Stroke Recovery: Findings From the STRONG Study

Abstract

Introduction: The STRONG (Stroke, sTress, RehabilitatiON, and Genetics) study has documented the role of cumulative lifetime stress/trauma exposure (LSE) in stroke recovery. Understanding the types of trauma most closely linked with functional outcomes may identify specific risk factors for stroke recovery. We examined specific types of life stress linked with functional and cognitive disability at 1-year post-stroke. Methods: Adults with a new stroke enrolled at 28 US sites were assessed 4 times over 1 year. Assessments included LSE 90 days post-stroke, and Stroke Impact Scale (SIS), modified Rankin Scale (mRS), & Telephone Montreal Cognitive Assessment (tMOCA) at 1-year post-stroke. Bivariate and multivariate analyses examined relationships among LSE and outcomes. Results: The 763 enrollees had age 63.1±14.9 yrs; initial NIHSS score 4 [2-9]; 41.2% Female; 69.4% White. Controlling for age, gender, race, and 3-mo NIHSS score, lifetime exposure to being raped was associated with worse SIS-ADL, mRS, and tMOCA scores 12-mo post-stroke. Several other LSE were also independently associated with worse 12-mo SIS-ADL scores: witnessing a family member be injured or killed, divorce, and emotional abuse. Having a loved one be seriously ill was associated with better 12-mo t-MOCA scores. These findings were robust when early post-stroke acute stress levels were also included in the model. Women were significantly more likely to report being raped, experiencing emotional abuse, and having a seriously ill loved one. Demographics were not significantly associated with divorce or witnessing a family member injured or killed. Conclusions: Assessing specific types of exposure to LSE early in the post-stroke period may help identify at-risk patients who might benefit from additional post-stroke support to enhance their long-term functional and cognitive abilities.