Evaluating the presentation of fatigue and apathy, their predictors, and their association with quality of life (QoL), among stroke survivors: An Australian cross-sectional study.

This cross-sectional study: (1) investigated the presentation (frequency and severity) of fatigue and apathy after stroke; (2) identified predictors of post-stroke fatigue and apathy; and (3) explored the association between the presentation of fatigue and apathy and personal characteristics and QoL. Physical and mental health assessments utilized validated instruments: Multi-dimensional Fatigue Inventory; Apathy Evaluation Scale Short Form 10; PROMIS-10 Global Health and overall QoL. Univariate and multivariate (logistic regression) data analyses were performed. Overall, 112 stroke survivors (mean age 62y) participated; 62.1% reported fatigue (38.3% severe) and 44.9% apathy. Regarding QoL: two-thirds (63.4%) reported Good (37.5%) or Very Good (25.9%) physical health; half (50.3%) had Good (26.1%) or Very Good (24.2%) mental health. Those with poorer physical health were 18-fold more likely to have severe fatigue (OR = 17.93; 95%CI: 1.75-183.65; p<.01). On univariate analyses, those with ≥ moderately severe disability were 6.28-fold more likely to have apathy (OR = 6.28; 95%CI: 2.18-18.05; p<.01); on multivariate analysis, only fatigue severity and poorer mental health predicted apathy. Unemployed participants had significantly higher fatigue scores alongside poorer physical and mental health. Two-thirds of participating stroke survivors experienced fatigue and half reported apathy, with QoL measures of global physical and mental health predicting each, respectively. To optimize the care and recovery of stroke survivors, there is a need to first identify those "at-risk" of post-stroke fatigue and apathy so that these can be managed. Routine screening in practice may assist in identifying at-risk stroke survivors.