Abstract
Objective
To investigate the impact of objective cognitive impairment, negative affect, and
fatigue on cognitive complaint in a postacute (mean=6.64±1.32mo) sample of patients
with ischemic stroke.
Design
Cross-sectional study.
Setting
Specialized stroke units at major metropolitan hospitals.
Participants
Patients with first-ever ischemic stroke (N=25) aged between 50 and 85 years with
relatively good neurologic recovery (National Institutes of Health Stroke Scale score
≤7) during the postacute period. Participants were excluded from the study if there
was a documented history of psychiatric illness, neurologic disease, dementia, or
a moderate or severe aphasia.
Interventions
Not applicable.
Main Outcome Measures
Cognitive complaint as measured by the A-B Neuropsychological Assessment Schedule.
Results
Ninety percent of the patients reported some level of cognitive difficulty in everyday
life. Fatigue, cognitive slowing, memory difficulties, and poor concentration were
the most frequently reported complaints. More than half of all participants had significant
impairment in at least 1 cognitive domain after their stroke. A standard multiple
regression was performed to evaluate the relative impact of negative affect, fatigue,
and objective cognitive functioning on subjective cognitive complaint. This model
accounted for 61% of the variance in total subjective cognitive complaint (R=.78, F3,21=10.96, P<.001), with depression being the only variable to make a significant independent
contribution to the prediction of subjective cognitive complaint.
Conclusions
Cognitive complaints are reported by almost all patients after a stroke. Although
50% of the participants had objective evidence of a cognitive impairment, neither
objective cognitive impairment nor fatigue predicted cognitive complaint independently
of negative affect. Clinicians who receive reports of cognitive complaints in the
postacute period after stroke should be alert to the possibility of psychological
distress in their patient.
Keywords
List of abbreviations:
ABNAS (A-B Neuropsychological Assessment Schedule), NIHSS (National Institutes of Health Stroke Scale), RBANS (Repeatable Battery for the Assessment of Neuropsychological Status)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 25, 2013
Footnotes
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
