22. European Stroke Conference 5 Behavioral disorders and post-stroke dementia 9:10 - 9:20 Communication and Low Mood (CALM) study: a multicentre randomised controlled trial evaluating behavioural therapy for low mood in stroke patients with aphasia S.A. Thomas1, M.F. Walker2, J.A. Macniven3, H. Haworth4, N.B. Lincoln5 University of Nottingham, Nottingham, UNITED KINGDOM1,University of Nottingham, Nottingham, UNITED KINGDOM2, University of Nottingham, Nottingham, UNITED KING-DOM3, Nottinghamshire Health Care Foundation Trust, Nottingham, UNITED KINGDOM4, University of Nottingham, Nottingham, UNITED KINGDOM5 Background: Low mood is common in stroke patients with aphasia. Studies of psychological interventions have usually excluded patients with communication difficulties. Behavioural ap-proaches may be appropriate as they do not require intact communication. The aim of this study was to evaluate behavioural therapy for treating low mood in stroke patients with aphasia. Methods: Multicentre randomised controlled trial which recruited patients with aphasia from hospital and community settings. Low mood was identified using the Stroke Aphasic Depres-sion Questionnaire (SADQH-10) and Visual Analog Mood Scales ‘sad’ item (VAMS). Patients with low mood were randomly allocated to receive behavioural therapy for up to three months from an assistant psychologist, or usual care. Blind outcome assessments of mood (SADQH-21, VAMS), self-esteem (Visual Analogue Self-Esteem Scale; VASES), and leisure activities (Not-tingham Leisure Questionnaire) were completed three and six months after randomisation. Car-er strain was assessed at six months. Results: Of the 230 patients who consented to have their mood assessed, 105 had low mood and were randomised (66 men, mean age 67 years). At three months, allocation to behavioural therapy was a significant predictor of SADQH-21 (Beta=-0.20, p=0.05), VAMS sad (Beta=- 0.22, p=0.03) and VASES (Beta=0.28, p=0.002). At six months, allocation to behavioural ther-apy was a significant predictor of SADQH-21 (Beta=-0.12, p=0.045). Summary scores using area under the curve showed significant differences between groups for VAMS ‘sad; (p=0.015), VASES (p=0.005) and SADQH-21 (p=0.003). Group allocation did not significantly predict lei-sure activities or carer strain (p=0.275-p=0.749). Conclusion: Behavioural therapy improved mood in patients with aphasia. There was no signif-icant benefit for leisure activities or carer strain. Further evaluation of this treatment approach with a larger sample size and with patients with more severe mood problems is recommended. 4 Behavioral disorders and post-stroke dementia 9:00 - 9:10 Long-term Cognitive Impairment after Stroke in Young Adults P. Schaapsmeerders1, N. Maaijwee2, E. van Dijk3, L. Rutten-Jacobs4, R. Arntz5, H. Schoonderwaldt6, L. Dorresteijn7, R. Kessels8, F.-E. de Leeuw9 Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Nijmegen Medical Centre, Nijmegen, THE NETH-ERLANDS1, Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Nijmegen Medical Centre, Nijmegen, THE NETHERLANDS2, Department of Neurology, Donders Institute for Brain, Cognition and Be-haviour, Centre for Neuroscience, Radboud University Nijmegen Medical Centre, Nijmegen, THE NETHERLANDS3, Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Nijmegen Medical Centre, Nijmegen, THE NETHERLANDS4, Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Nijmegen Medical Centre, Nijme-gen, THE NETHERLANDS5, Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Nijmegen Medical Centre, Ni-jmegen, THE NETHERLANDS6, Department of Neurology, Medisch Spectrum Twente., En-schede, THE NETHERLANDS7, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience and Centre for Cognition, Radboud University Nijmegen, Nijmegen, THE NETHERLANDS8, Department of Neurology, Donders Institute for Brain, Cognition and Be-haviour, Centre for Neuroscience, Radboud University Nijmegen Medical Centre, Nijmegen, THE NETHERLANDS9 Background: Cognitive deficits are common and disabling sequela of stroke, especially in the young (aged 18-50years) since work, running a family, having an active life put high demands on patients’ cognitive abilities. No studies exist on risk factors for long-term cognitive impairment in the young. Methods: The FUTURE study comprises all consecutive stroke/TIA patients, aged 18-50, included in a prospective registry between 1980-2010. Composite Z-scores were calculated for processing speed, working memory, executive functioning and attention. Cognitive impairment CIs was defined as >1.5SD below age-adjusted mean of controls. Logistic regression was used to inves-tigate the relation between NIHSS at onset, recurrent stroke and cognitive impairment at fol-low- up adjusting for sex, follow-up duration and age of onset. Results: 270 ischemic stroke patients (follow-up:10.9years(SD:8.2); current age:50.7(SD:10.3) and 160 TIA patients participated (follow-up:8.7years(SD:8.3); current age:49.7(SD:11.2)). CIs in isch-emic stroke patients varied between 24.6-34.8% and in TIA between 11.0-16.3%. In ischemic stroke patients NIHSS and recurrent stroke were most consistently associated with long-term cognitive impairment. After adjusting for follow-up duration, sex and age, cognitive impair-ment was still associated with recurrent stroke (processing speed adjusted OR:3.1, 95%CI 1.6- 6.0; working memory OR:3.4, 95%CI 1.7-6.8; attention OR:2.5, 95%CI 1.3-5.1) and NIHSS (processing speed OR:1.1, 95%CI 1.0-1.3; working memory OR:1.1, 95%CI 1.1-1.2). Selected baseline characteristics were not associated with CIs in TIA, except for NIHSS and attention deficits(OR:1.2, 95%CI 1.0-1.4) after adjusting for confounders. Conclusion: Baseline stroke severity and recurrent stroke predict long-term cognitive impairment. These patients should be informed and their cognitive function should be monitored. Future research should focus on factors that might improve cognition in these patients. 188 © 2013 S. Karger AG, Basel Scientific Programme
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