Cognitive and Physical Functions in Patients With Transient Ischemic Attack. A Randomized Controlled Trial of Physical Activity on Prescription up to One Year After the Event

• Change in Cognition and Mental Fatigue [ Time Frame: All measures at baseline 3, 6 and 12 month after the event ] [ Designated as safety issue: No ]
  Change in mental conditions over time measured with Self report of mental fatigue and related symptoms. This is a scale with 7 different steps for graduate mental fatigue. Less points indicate less mental fatigue.
• Change in 6MWT [ Time Frame: 3.6 and 12 month ] [ Designated as safety issue: No ]
  Change in Walking endurance measured in 3,6, 12 month measured with 6 MWT (six minutes Walking Test).
• Change in Self reported Stages of change [ Time Frame: 3,6,12 month ] [ Designated as safety issue: No ]
  A self reported questionnaire that measures willingness to changes in physical activity over time. The scale has diffrent levels of willingness for changes in physical activity
• Change from baseline in systolic Bloodpressure at 12 months [ Time Frame: 3,6,12 ] [ Designated as safety issue: No ]
• BMI [ Time Frame: 12 month ] [ Designated as safety issue: No ]
  Body Mass Index is measured in the start and in the end of the study
• Change in mental capacity over a period of time [ Time Frame: 3,6,12 month ] [ Designated as safety issue: No ]
  Change in mental capacity mesured with a assemssment called Cognistat that indicates four diffrents levels of mental capacity.

The purpose of this study is to determine whether Physical Activation on Prescription can help patients with TIA to become more physically active.

One group will receive Physical Activation on Prescription (PaP)and the other group will receive usual care.

And to identify if persons with TIA presents with cognitive impairments.

Transient ischemic attack (TIA) is a transient episode of neurologic dysfunction caused by ischemia, i.e. loss of blood flow. The symptoms of a TIA typically resolve within 24 hours. Attacks lasting more than 30 minutes are unusual. TIAs and strokes present with the same symptoms such as sudden weakness, numbness, sudden dimming or loss of vision, aphasia, slurred speech, facial palsy and mental impairments. Subtle problems with cognitive functions and fatigue may not always be addressed before discharge. However, even subtle mental impairments are important to identify, given the problems they might pose.

• Experimental: Physical activity on Prescription (PaP)
  Intervention group receivies a PaP for 12 month.
  Intervention: Other: Physical activation on Prescription
• No Intervention: Control Group
  The control group has the same monitoring as the experimental group but receives no PaP.
• No Intervention: Cognitiv function in patients with TIA

  Before discharged from hospital cognitive function is assessed. At the first visit the patients fill in a self assessment questionnaire for mental fatigue.

  If impaired at the previous assessment cognitive function will be assessed at 3, 6 and 12 month.

• No Intervention: Controlgroup Cognitive function
  In order to determine whether hospitalization in itself is associated with transient impaired cognition, a comparison group will be included. The comparison group will consist of patients with angina pectoris consecutively admitted to the Norrtälje Hospital. The patients with angina pectoris will be age and sex matched with the patients with TIA and assessed for cognitive function when their angina symptoms have subsided.

Inclusion Criteria:

• Understand Swedish language (also in and writing), living in Norrtälje community,
• To participate in the assessment of cognitive function: no known cognitive impairments before the TIA event and history of stroke.

Exclusion Criteria:

• Presence of contraindicatons to exercise, and no history of stroke