Trends in Diagnosis‐Specific Work Disability Before and After Stroke: A Longitudinal Population‐Based Study in Sweden

Lallukka, Tea; Ervasti, Jenni; Lundström, Erik; Mittendorfer‐Rutz, Ellenor; Friberg, Emilie; Virtanen, Marianna; Alexanderson, Kristina

doi:10.1161/jaha.117.006991

Cited by 24 publications

(12 citation statements)

References 25 publications

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“…Although stroke is the third leading cause of death after heart disease and cancer, it leads to permanent disabilities in 80% of survivors [1, 2]. Stroke can be classified into ischemic or hemorrhagic, in which 85% of strokes are ischemic [3].…”

Section: Introductionmentioning

confidence: 99%

Neuroinflammation: friend and foe for ischemic stroke

Jayaraj

Azimullah

Beiram

et al. 2019

J Neuroinflammation

868

695

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Stroke, the third leading cause of death and disability worldwide, is undergoing a change in perspective with the emergence of new ideas on neurodegeneration. The concept that stroke is a disorder solely of blood vessels has been expanded to include the effects of a detrimental interaction between glia, neurons, vascular cells, and matrix components, which is collectively referred to as the neurovascular unit. Following the acute stroke, the majority of which are ischemic, there is secondary neuroinflammation that both promotes further injury, resulting in cell death, but conversely plays a beneficial role, by promoting recovery. The proinflammatory signals from immune mediators rapidly activate resident cells and influence infiltration of a wide range of inflammatory cells (neutrophils, monocytes/macrophages, different subtypes of T cells, and other inflammatory cells) into the ischemic region exacerbating brain damage. In this review, we discuss how neuroinflammation has both beneficial as well as detrimental roles and recent therapeutic strategies to combat pathological responses. Here, we also focus on time-dependent entry of immune cells to the ischemic area and the impact of other pathological mediators, including oxidative stress, excitotoxicity, matrix metalloproteinases (MMPs), high-mobility group box 1 (HMGB1), arachidonic acid metabolites, mitogen-activated protein kinase (MAPK), and post-translational modifications that could potentially perpetuate ischemic brain damage after the acute injury. Understanding the time-dependent role of inflammatory factors could help in developing new diagnostic, prognostic, and therapeutic neuroprotective strategies for post-stroke inflammation.

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Section: Introductionmentioning

confidence: 99%

Neuroinflammation: friend and foe for ischemic stroke

Jayaraj

Azimullah

Beiram

et al. 2019

J Neuroinflammation

868

695

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“…However, it is common that people have several diseases and disabilities [ 8 ]. For example, people in a risk for stroke have increased work absence, risk of premature death, disability and unemployment even without the stroke event [ 9 – 12 ]. Also, HCM has been criticized for ignoring the possibility of employee replacement [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Adjusted productivity costs of stroke by human capital and friction cost methods: a Northern Finland Birth Cohort 1966 study

et al. 2021

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Background Productivity costs result from loss of paid and unpaid work and replacements due to morbidity and mortality. They are usually assessed in health economic evaluations with human capital method (HCM) or friction cost method (FCM). The methodology for estimating lost productivity is an area of considerable debate. Objective To compare traditional and adjusted HCM and FCM productivity cost estimates among young stroke patients. Methods The Northern Finland Birth Cohort 1966 was followed until the age of 50 to identify all 339 stroke patients whose productivity costs were estimated with traditional, occupation-specific and adjusted HCM and FCM models by using detailed, national register-based data on care, disability, mortality, education, taxation and labour market. Results Compared to traditional HCM, taking into account occupational class, national unemployment rate, disability-free life expectancy and decline in work ability, the productivity cost estimate decreased by a third, from €255,960 to €166,050. When traditional FCM was adjusted for occupational class and national unemployment rate, the estimate more than doubled from €3,040 to €7,020. HCM was more sensitive to adjustments for discount rate and wage growth rate than FCM. Conclusions This study highlights the importance of adjustments of HCM and FCM. Routine register-based data can be used for accurate productivity cost estimates of health shocks.

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“…Initially, marital status was also considered (married or single), but due to the young age at cohort entry for most participants, the covariate was not very relevant, and it was omitted from subsequent analyses. Classifications further broadly follow our previous procedures [19][20][21].…”

Section: Covariatesmentioning

confidence: 99%

Unemployment Trajectories and the Early Risk of Disability Pension among Young People with and without Autism Spectrum Disorder: A Nationwide Study in Sweden

Lallukka

Mittendorfer‐Rutz

Ervasti

et al. 2020

IJERPH

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Depression and anxiety are associated with unemployment and disability pension, while autism spectrum disorder (ASD) is less studied. We aimed to first identify unemployment trajectories among young adults with and without ASD, and then to examine their social determinants. Finally, we used the trajectories as determinants for subsequent disability pension. We used a population-based cohort, including 814 people who were 19–35 years old, not on disability pension, and who had their ASD diagnosis between 2001 and 2009. A matched reference population included 22,013 people with no record of mental disorders. Unemployment follow-up was the inclusion year and four years after. Disability pension follow-up started after the unemployment follow-up and continued through 2013. We identified three distinctive trajectories of unemployment during the follow-up: (1) low, then sharply increasing (9%,) (2) low (reference, 67%), and (3) high then slowly decreasing (24%). People with ASD had higher odds of belonging belong to the trajectory groups 1 (OR 2.53, 95% CI 2.02–3.18) and 3 (OR 3.60, 95% CI 3.08–4.19). However, the mean number of unemployment days was relatively low in all groups. A disability pension was a rare event in the cohort, although memberships to groups 1 and 3 were associated with the risk of a future disability pension. More knowledge is needed about factors facilitating participation in paid employment among people with ASD.

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Trends in Diagnosis‐Specific Work Disability Before and After Stroke: A Longitudinal Population‐Based Study in Sweden

Cited by 24 publications

References 25 publications

Neuroinflammation: friend and foe for ischemic stroke

Neuroinflammation: friend and foe for ischemic stroke

Adjusted productivity costs of stroke by human capital and friction cost methods: a Northern Finland Birth Cohort 1966 study

Unemployment Trajectories and the Early Risk of Disability Pension among Young People with and without Autism Spectrum Disorder: A Nationwide Study in Sweden

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