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Title

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

Authors

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

Abstract

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.

Subjects

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

Publication

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

ISSN

0963-8288

Publication type

Academic Journal

DOI

10.1080/09638288.2024.2340121

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