The frequency and determinants of executive dysfunction among patients with subacute phase of ischemic stroke in West Nusa Tenggara, Indonesia

Abstract

Background: Executive dysfunction is a common form of intellectual weakening that interferes with the functional activity of the stroke survivors. Detection of executive dysfunction in the subacute segment of ischemic stroke allows the patients to receive appropriate interventions for optimal clinical outcomes. This study aims to investigate the frequency and determinants of executive dysfunction among subacute ischemic stroke patients in West Nusa Tenggara. Methods: This study involved 192 subjects divided into two groups: ischemic stroke (n=96) and control groups (n=96). Categorical data collected from both ischemic stroke and control subjects were age, gender, education level, occupation, hypertension, diabetes mellitus, Trail Making Test Part B, verbal fluency test, backward digit span scores and executive function status. Besides the data previously mentioned, clinical data that were also collected in ischemic stroke subjects was infarct size. The significant difference in the frequency of executive dysfunction between ischemic stroke and control groups was analyzed using chi-square test. The association between the determinants of executive dysfunction and the frequency of this executive dysfunction was analyzed using logistic regression. Results: This study discovered that the frequency of executive dysfunction among subjects with subacute phase of ischemic stroke was 52.1% and it was significantly higher compared with controls (p<0.0001). Further, lower education level was the only determinant significantly correlated with the increased risk of executive dysfunction in the subjects (Odds ratio [OR] =3.47; 95% confidence interval [CI] = 1.47 – 10.26). Conclusion: There was high frequency of subacute ischemic stroke-associated executive dysfunction associated with lower education level.