Fatigue after transient ischemic attack: cross-sectional associations with comorbidities, activities of daily living and social participation

Background and objectives Fatigue is a common symptom during the first year after transient ischemic attack (TIA), but its long-term persistence remain unclear. This study aim to assessed long-term perceived fatigue after TIA and to evaluated associated comorbidities and functional consequences. Materials and methods This observational and cross-sectional study included 431 community-dwelling adults assessed 1–13 years after TIA in an outpatient setting, with a 25% response rate. Fatigue was measured using the Fatigue Assessment Scale in three subgroups: first-ever TIA ( n = 299), recurrent TIA ( n = 54), and TIA with stroke ( n = 78). Depression and anxiety were evaluated using the Hospital Anxiety and Depression Scale, and. An activities of daily living and social participation using were determined using the Stroke Impact Scale. Multivariable ordinal linear regression analyses were performed in the first-ever TIA group to examine associations between fatigue, comorbidities and functional outcomes. Results In the first-ever TIA group, fatigue levels were similar across time-since-TIA strata up to 13 years (mean 21.8, standard deviation [SD] 5.2); 35% exceeded the fatigue cut-off. Fatigue in the first-ever TIA group was lower than in the recurrent TIA group (mean 23.9, SD 5.7; p < 0.05) and TIA with stroke group (mean 23.8, SD 6.5; p < 0.05). Amon participants with first-ever TIA, depression (β = 6.8, 95% confidence interval [CI] 3.5–10.1; p < 0.001), severe sleep problem (category 4: β = 3.9, 95% CI 0.9–6.8; p = 0.010) and (category 5: β = 5.9, 95% CI 2.2–9.6; p = 0.002), atrial fibrillation (β = 2.1, 95% CI 0.3–3.9; p = 0.02) and heart disease (β = 1.8, 95% CI 0.2–3.4; p = 0.03) were associated with higher fatigue. Higher fatigue was also associated with reduced activities of daily living (β = 0.15, 95% CI 0.07–0.22, p < 0.001) and lower social participation (β = 0.06, 95% CI 0.02–0.10; p = 0.004). Conclusion Fatigue affected more than one-third of first-ever TIA survivors and did not differ materially across cross-sectional time-since-TIA strata up to 13 years. Greater fatigue was associated with depressive symptoms, severe sleep problems, atrial fibrillation, heart disease, and reduced daily activity and social participation. Early identification and management of fatigue and related comorbidities may improve functioning. Longitudinal studies are needed to determine temporal relationships and whether targeted management improves outcomes.