Laura E Middleton1, Benjamin Lam2, Halla Fahmi3, Sandra E Black4, William E McIlroy1, Donald T Stuss5, Cynthia Danells6, Jon Ween7, Gary R Turner8. 1. Department of Kinesiology, University of Waterloo, Waterloo, Canada Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Research Institute, Toronto, Canada Toronto Rehabilitation Institute, Toronto, Canada. 2. Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Research Institute, Toronto, Canada Department of Neurology, Sunnybrook Health Sciences Centre, Toronto, Canada Department of Medicine, University of Toronto, Toronto, Canada. 3. Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Research Institute, Toronto, Canada Department of Medicine, University of Toronto, Toronto, Canada. 4. Toronto Rehabilitation Institute, Toronto, Canada Department of Neurology, Sunnybrook Health Sciences Centre, Toronto, Canada Department of Medicine, University of Toronto, Toronto, Canada. 5. Department of Medicine, University of Toronto, Toronto, Canada Department of Psychology, University of Toronto, Toronto, Canada Rotman Research Institute of Baycrest, Toronto, Canada. 6. Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Research Institute, Toronto, Canada Toronto Rehabilitation Institute, Toronto, Canada. 7. Rockwood Epilepsy and Stroke Center, Spokane, WA, USA. 8. Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Research Institute, Toronto, Canada Department of Psychology, York University, Toronto, Canada.
Abstract
BACKGROUND: Functional contributions of cognitive impairment may vary by domain and severity. OBJECTIVE: (1) To characterize frequency of cognitive impairment by domain after stroke by severity (mild: -1.5 ≤ z-score < -2; severe: Z ≤ -2) and time (sub-acute: < 90d; chronic: 90d-2yrs); and (2) To assess the association of cognitive impairment with function in chronic stroke. METHODS: Cognitive function was characterized among 215 people with sub-acute or chronic stroke (66.8 years, 43.3% female). Z-scores by cognitive domain were determined from normative data. Function was defined as the number of IADLs minimally independent. RESULTS: 76.3% of sub-acute and 67.3% of chronic stroke participants had cognitive impairment in ≥ 1 domain (p-for-difference = 0.09). Severe impairment was most common in psychomotor speed (sub-acute: 53.5%; chronic: 33.7%). Impairment in executive function was common (sub-acute: 39.5%; chronic: 30.7%) but was usually mild. Severe impairment in psychomotor speed, visuospatial function, and language and any impairment in executive function and memory was associated with IADL impairment (p < 0.03). CONCLUSIONS: Mild cognitive impairment is common after stroke but is not associated with functional disability. Impairment in psychomotor speed, executive function, and visuospatial function is common and associated with functional impairment so should be a focus of screening and rehabilitation post-stroke.
BACKGROUND: Functional contributions of cognitive impairment may vary by domain and severity. OBJECTIVE: (1) To characterize frequency of cognitive impairment by domain after stroke by severity (mild: -1.5 ≤ z-score < -2; severe: Z ≤ -2) and time (sub-acute: < 90d; chronic: 90d-2yrs); and (2) To assess the association of cognitive impairment with function in chronic stroke. METHODS: Cognitive function was characterized among 215 people with sub-acute or chronic stroke (66.8 years, 43.3% female). Z-scores by cognitive domain were determined from normative data. Function was defined as the number of IADLs minimally independent. RESULTS: 76.3% of sub-acute and 67.3% of chronic strokeparticipants had cognitive impairment in ≥ 1 domain (p-for-difference = 0.09). Severe impairment was most common in psychomotor speed (sub-acute: 53.5%; chronic: 33.7%). Impairment in executive function was common (sub-acute: 39.5%; chronic: 30.7%) but was usually mild. Severe impairment in psychomotor speed, visuospatial function, and language and any impairment in executive function and memory was associated with IADL impairment (p < 0.03). CONCLUSIONS: Mild cognitive impairment is common after stroke but is not associated with functional disability. Impairment in psychomotor speed, executive function, and visuospatial function is common and associated with functional impairment so should be a focus of screening and rehabilitation post-stroke.
Authors: Elizabeth A Crago; Thomas J Price; Catherine M Bender; Dianxu Ren; Samuel M Poloyac; Paula R Sherwood Journal: J Neurosci Nurs Date: 2016-10 Impact factor: 1.230
Authors: Bradley J MacIntosh; Jodi D Edwards; Mani Kang; Hugo Cogo-Moreira; Joyce L Chen; George Mochizuki; Nathan Herrmann; Walter Swardfager Journal: Front Aging Neurosci Date: 2017-10-31 Impact factor: 5.750
Authors: Renate M van de Ven; Jessika I V Buitenweg; Ben Schmand; Dick J Veltman; Justine A Aaronson; Tanja C W Nijboer; Suzanne J C Kruiper-Doesborgh; Coen A M van Bennekom; Sascha M C Rasquin; K Richard Ridderinkhof; Jaap M J Murre Journal: PLoS One Date: 2017-03-03 Impact factor: 3.240