Abstract TMP92: Keep On Working. Occupational Status Before and After Stroke Protects the Brain, General Health and Cognitive Status
Bibliographic record
Abstract
Background: Stroke considerably increases the risk of dementia, while occupational status may influence physically and mentally long-term outcome after the event. We aimed to evaluate the interrelationship between occupational status, brain pathology on imaging and cognitive decline in a longitudinal post-stroke cohort. Methods: Data from 252 persons at working age (&lt;65 years), with first-ever stroke from the TABASCO study was available. All patients underwent 3T MRI, inflammatory markers and cognitive assessment during the acute phase, 12 and 24 months thereafter. Results: The working rate before stroke was 68.7%, and 60.4% 12 months later. Pre-stroke unemployment was associated with reduced cortical thickness and white matter volume, severity of the neurological deficit, poorer cognitive scores at 12 and 24 months, higher depression scores, and elevated inflammation (p=0.002, p=0.049, p=0.001, p=0.002, p<0.001, p=0.011, p<0.001, p=0.02, respectively). Unemployed subjects suffered also from higher prevalence of Type 2 diabetes mellitus (T2DM) and hypertension compared to employed subjects (p=0.016, p=0.006, respectively). During the follow-up, 4.4% of the participants died and 8.9% developed cognitive decline. Mortality and cognitive decline were higher among unemployed compared to employed participants (p<0.001, p=0.001, respectively). Multiple regression, controlling for age, sex, education, vascular risk factors, and ApoE4, revealed that T2DM, stroke severity and pre-stroke unemployment were independent predictors of this decline (OR=3.2, 5.2, 3.2, respectively); while gender and pre-stroke unemployment predicted mortality (OR=11.4,16.2, respectively). Return to work after the event was also associated with decreased prevalence of cognitive decline. Conclusions: Pre-stroke unemployment was independently associated with brain atrophy, depression, higher mortality, and poorer performance in cognitive evaluation 2 years post-stroke. T2DM, stroke severity and pre-stroke unemployment were independent predictors of this decline, as well as early retirement after the stroke. These results emphasizing the advantage of employment versus early retirement in an attempt to reserve health and cognitive abilities.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".