Domain-specific cognitive impairments, mood and quality of life 6 months after stroke.

Milosevich, Elise; Kusec, Andrea; Pendlebury, Sarah T.; Demeyere, Nele

Purpose: To identify which acute and 6-month domain-specific cognitive impairments impact mood, participation, and stroke-related quality of life 6 months post-stroke. Materials and methods: A prospective cohort of 430 stroke survivors completed the Oxford Cognitive Screen (OCS) acutely and 6 months post-stroke. Participants completed the Stroke Impact Scale (SIS) and Hospital Depression and Anxiety Scale (HADS) at 6 months. Multivariable regression analyses assessed whether severity of, and domain-specific, cognitive impairment acutely and at 6 months was associated with composite 6-month SIS scores, each SIS subscale, and HADS scores. Results: Increased severity of acute and 6-month cognitive impairment was associated with lower 6-month SIS composite scores independent of age, sex, education years, and stroke severity (both p < 0.001). Domain-specific impairments in memory (p < 0.001) and attention (p = 0.002) acutely, and language (p < 0.001), memory (p = 0.001) and number processing (p = 0.006) at 6 months showed the strongest associations with worse SIS composite scores. Severity of acute and 6-month cognitive impairment was associated with poorer functioning in each SIS subscale, and greater levels of depression (acute p = 0.021, 6-months p < 0.001), but not anxiety (p = 0.174, p = 0.129). Conclusions: Both acute and 6-month domain-specific cognitive impairments, particularly in memory, were found to negatively impact overall functional and mood outcomes 6 months post-stroke. IMPLICATIONS FOR REHABILITATION: At 6 months follow-up, stroke survivors reported the greatest challenges in participation and emotional well-being, suggesting that these specific areas may be worth prioritising. Healthcare professionals involved in post-stroke rehabilitation should prioritize assessing and addressing the severity of post-stroke cognitive impairment as it significantly influences functioning. Implementing targeted interventions particularly for memory deficits could be instrumental in improving overall functional and mood outcomes in stroke survivors.

UNITED Kingdom; NIH Stroke Scale; SELF-evaluation; STROKE units; RESEARCH funding; MULTIPLE regression analysis; FUNCTIONAL status; SEVERITY of illness index; ANXIETY; DESCRIPTIVE statistics; LONGITUDINAL method; COGNITION disorders; QUALITY of life; LANGUAGE disorders; AFFECT (Psychology); STROKE patients; PSYCHOLOGICAL tests; DATA analysis software; PSYCHOSOCIAL factors; MEMORY disorders; MENTAL depression; ACTIVITIES of daily living

Disability & Rehabilitation, 2025, Vol 47, Issue 2, p435

0963-8288

Academic Journal

10.1080/09638288.2024.2340121