Cognitive complaints in the early phase after stroke are not indicative of cognitive impairment

Duits, Annelien; Munnecom, T; Heugten, Caroline van; Oostenbrugge, Robert J. van

doi:10.1136/jnnp.2007.114595

Cited by 64 publications

(81 citation statements)

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“…4 In addition, no association between SCF and cognitive performance was found in patients with stroke. 3,5 It is possible that this association is only apparent in healthy people, without a preceding symptomatic event, such as a stroke. This might reduce the occurrence of problems in adjustment, such as anxiety and depression, after an event.…”

Section: Discussionmentioning

confidence: 99%

“…The relationship with objective cognitive performance on neuropsychological assessment is unclear. Although most studies showed no relationship with objective cognitive impairment when corrected for mood and health, [1][2][3][4][5][6] some studies reported positive associations. 7,8 However, studies have shown a strong association with poor physical health 6 and depression.…”

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confidence: 99%

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Subjective Cognitive Failures in Patients With Hypertension Are Related to Cognitive Performance and Cerebral Microbleeds

et al. 2014

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Subjective cognitive failures (SCF) are a common feature in elderly people with cardiovascular disease.1 SCF are personal experiences of cognitive problems in everyday life, such as difficulties in memory (eg, forgetfulness), information processing speed (eg, slowness in performing simple tasks), and executive function (eg, problems in planning or reasoning). Although these subjective problems are common, it is not completely clear what they represent. The relationship with objective cognitive performance on neuropsychological assessment is unclear. Although most studies showed no relationship with objective cognitive impairment when corrected for mood and health, 1-6 some studies reported positive associations. 7,8 However, studies have shown a strong association with poor physical health 6 and depression. 2,6Research on SCF in patients with hypertension is scarce, despite the increasing support for an association between hypertension and objective cognitive impairment, 9-11 which might be because of brain damage. Hypertension is a major risk factor for white matter hyperintensities (WMH) 12 and other magnetic resonance imaging (MRI) manifestations of cerebral small vessel disease (cSVD), 13 which include lacunes, cerebral microbleeds, and perivascular spaces.14 A possible association between SCF and cSVD-related brain damage, as proposed by previous research, 1,15,16 and objective cognitive impairment has not been examined before in patients with hypertension.Patients with hypertension expressing SCF may be a recognizable situation for clinicians. To gain more knowledge about the implications of SCF in patients with hypertension, this study investigated whether SCF are associated with objective cognitive impairment, independent of confounding factors, such as age, sex, symptoms of anxiety and depression, and vascular risk factors. In addition, we examined whether SCF are predictive for the presence of MRI markers of cSVD.Abstract-Previous studies on the relationship between subjective cognitive failures (SCF) and objective cognitive function have shown inconsistent results. In addition, research on the association between SCF and imaging markers of cerebral small vessel disease is limited. We investigated whether SCF in patients with essential hypertension, who are at high risk of cerebral small vessel disease, are associated with objective cognitive function and magnetic resonance imaging manifestations of cerebral small vessel disease. We included 109 patients with hypertension who underwent extensive neuropsychological assessment, including questionnaires measuring SCF and symptoms of anxiety and depression. Brain magnetic resonance imaging was performed to rate the presence of lacunes, cerebral microbleeds, and perivascular spaces, as well as white matter hyperintensities volume. Results showed significant associations between SCF and objectively measured overall cognition (B=−0.02; 95% confidence interval=−0.03 to −0.005), memory (B=0.02; 95% confidence interval=−0.03 to −0.004), and information processin...

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Subjective Cognitive Failures in Patients With Hypertension Are Related to Cognitive Performance and Cerebral Microbleeds

et al. 2014

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“…In the past decades, the neuropsychological literature has consistently reported that cognitive impairment is commonly observed after stroke and might affect up to 50% of stroke patients (e.g., Duits et al, 2008). This finding is reason for concern, as the presence of cognitive impairment has been associated with a negative influence on the outcome as well as with significant functional problems in daily life (e.g., Galski et al, 1993;Zinn et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

“…This finding is reason for concern, as the presence of cognitive impairment has been associated with a negative influence on the outcome as well as with significant functional problems in daily life (e.g., Galski et al, 1993;Zinn et al, 2004). It is thus vitally important to adequately assess cognitive problems after stroke, given that the information obtained from the assessment can contribute to the rehabilitation treatment, for instance in establishing the treatment strategy or in providing advice to patients and their caregivers (Duits et al, 2008). It should, however, also be noted that an extensive cognitive assessment is a rather costly and time-consuming procedure that might not be required for all stroke patients.…”

Section: Introductionmentioning

confidence: 99%

The Wayfinding Questionnaire as a Self-report Screening Instrument for Navigation-related Complaints After Stroke: Internal Validity in Healthy Respondents and Chronic Mild Stroke Patients

Claessen

Visser‐Meily

Rooij

et al. 2016

Arch Clin Neuropsychol

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Objective: In current stroke care, cognitive problems are usually diagnosed in a stepwise manner. More specifically, screening instruments are first applied to support healthcare professionals in deciding whether a second step (an extensive assessment) would be appropriate. None of the existing screening instruments, however, takes navigation ability into account. This is problematic, as navigation impairment after stroke has been shown to be common, more so than previously thought. The Wayfinding Questionnaire (WQ) is therefore presented as a screening instrument for navigation-related complaints after stroke. The internal validity of the WQ was investigated in two samples of participants to establish the final version. Method and Results: In Study 1, the WQ was administered in a representative sample of 356 healthy participants. Its factor structure was investigated using a principal component analysis. This procedure resulted in deletion of four items and revealed a three-factor structure: "Navigation and Orientation," "Spatial Anxiety," and "Distance Estimation". In Study 2, a confirmatory analysis was performed to directly verify the factor structure as obtained in Study 1 based on data of 158 chronic mild stroke patients. Fit indices of the confirmatory analysis indicated acceptable model fit. The reliability of the three subscales was found to be very good in both healthy participants and patients. Conclusions: These studies allowed us to determine the final version of the WQ. The results indicated that the WQ is an internally valid and reliable instrument that can be interpreted using a three-factor structure in both healthy respondents and chronic mild stroke patients.

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“…These complaints occur early after stroke and often remain present until years after the event (Carlsson, Moller, & Blomstrand, 2003;Duits, Munnecom, van Heugten, & van Oostenbrugge, 2008;Nijsse et al, 2017;Wendel, Risberg, Pessah-Rasmussen, Stahl, & Iwarsson, 2008). The most commonly reported SCC in this population include mental slowness, concentration difficulties and memory problems (van Rijsbergen et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Psychological factors and subjective cognitive complaints after stroke: Beyond depression and anxiety

Rijsbergen

Mark

Kop

et al. 2018

Neuropsychological Rehabilitation

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Subjective Cognitive Complaints (SCC) are common after stroke and adversely affect quality of life. In the present study, we determined the associations of depression, anxiety, perceived stress and fatigue with post-stroke SCC, and whether these associations were independent of objective cognitive functioning, stroke characteristics and individual differences in personality traits and coping styles. Using a cross-sectional design, SCC and psychological measures were obtained in 208 patients (mean 3.3 ± 0.5 months after stroke; 65.9% men; mean age 64.9 ± 12.4 years). SCC were assessed using the Checklist for Cognitive and Emotional consequences following stroke (CLCE) inventory. Validated questionnaires were used to measure depression and anxiety (Hospital Anxiety and Depression Scale), perceived stress (Perceived Stress Scale), fatigue (Fatigue Assessment Scale), personality traits (Eysenck Personality Questionnaire Revised Short Scale) and coping style (Utrecht Coping List). Multivariate hierarchical linear regression analyses were used to adjust for covariates. Depression (β = 0.35), anxiety (β = 0.38), perceived stress (β = 0.39), and fatigue (β = 0.39) were associated with CLCE scores, independent of demographic, cognitive performance and stroke-related covariates. After including personality traits and coping styles in the model, independent associations with CLCE scores were found for fatigue (β = 0.26, p = .003) and neuroticism (β = 0.21, p = .05). Interventions aimed at improving psychological resilience and increasing energy levels might be a worthwhile addition to stroke rehabilitation programmes by reducing SCC and improving quality of life. ARTICLE HISTORY

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Cognitive complaints in the early phase after stroke are not indicative of cognitive impairment

Abstract: Cognitive complaints hindering daily life are frequently reported in the early weeks after stroke but are no indication for impaired cognitive performance. To identify patients with cognitive impairment, neuropsychological assessment is essential.

Cited by 64 publications

References 30 publications

Subjective Cognitive Failures in Patients With Hypertension Are Related to Cognitive Performance and Cerebral Microbleeds

Subjective Cognitive Failures in Patients With Hypertension Are Related to Cognitive Performance and Cerebral Microbleeds

The Wayfinding Questionnaire as a Self-report Screening Instrument for Navigation-related Complaints After Stroke: Internal Validity in Healthy Respondents and Chronic Mild Stroke Patients

Psychological factors and subjective cognitive complaints after stroke: Beyond depression and anxiety

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