Change characteristics of health-related quality of life and its association with post-stroke fatigue at four-year follow-up

Objective: To explore trajectories that describe change in post-stroke health-related quality of life with fatigue as outcome. Design: Observational and prospective study. Subjects: Stroke survivors (N = 144) with predomi-nantly mild or moderate strokes. Methods: The multidimensional Stroke-Specific Quality of Life scale was used at 1 and 4 years, and the Fatigue Severity Scale at 4 years post-stroke. Latent class growth analyses were used as per-son-oriented analyses to identify meaningful tra-jectories. Socio-demographic and stroke-related covariables provided customary adjustment of the outcome, as well as prediction of class membership. Results: The latent class growth analysis models were estimated for "physical health", "visual -language", and "cognitive-social-mental" compo-nents of the Stroke-Specific Quality of Life scale, which extracted trajectories describing a variation in stable, deteriorating and improving functional patterns. The stable, well-functioning trajectory was most frequent across all components. More pronounced fatigue was associated with trajecto-ries describing worse functioning, which was more prominent among females compared with males. Living alone implied more fatigue in the "cognitive -social-mental" component. Within the "visual -lang-uage" components' trajectories, younger and older participants reported more fatigue compared with middle-aged participants. Conclusion: Most participants belonged to the sta-ble, well-functioning trajectories, which showed a consistently lower level of fatigue compared with the other trajectories.