Domain-Specific Cognitive Recovery after First-Ever Stroke: A 2-Year Follow-Up

Abstract

Most of the cognitive improvement took place within 6 months. Long-lasting cognitive impairment was common even after good neurological recovery. An early neuropsychological examination is essential in evaluating cognitive dysfunction and need for rehabilitation. (JINS, 2018, 24, 117-127).

Prevalence and short‐term changes of cognitive dysfunction in young ischaemic stroke patients

“…This prospective FU study indicates that cognitive impairment is highly prevalent in young patients with acute ischaemic stroke and still affects a third of them after 3 months. In line with prior studies, processing speed, assessed by the SDMT, was most severely impaired at baseline . Furthermore, flexibility/executive function was impaired in almost half of young patients at baseline and still in 40% 3 months after stroke.…”

“…In this regard, important insights are expected from the ongoing Observational Dutch Young Symptomatic Stroke Study (ODYSSEY), which aims to include 1500 patients and will be assessing cognitive function 6 weeks and 1 year after the index event . A recent study suggests that most cognitive recovery happens within the first 6 months, with little change thereafter , highlighting the importance of exploring the dynamic course of post‐stroke cognitive impairment especially early on.…”

“…None of the above mentioned studies explored the course of cognitive impairment by assessing the same cohort twice which precludes information on the dynamics of post‐stroke cognitive function and thus may lead to an overestimation or underestimation of the problem due to improvement or deterioration over time. A recent study, investigating patients from 18 to 65 years, showed that cognitive function mostly improves within the first 6 months post‐stroke, with only little cognitive recovery thereafter, highlighting the fact that changes occur mostly early on .…”

“…Although it has been shown that early neuropsychological information provides valid information to predict post‐stroke functional outcome , in acute stroke usually short cognitive screening tests rather than a comprehensive neuropsychological test battery are used, although the precision of these instruments has been questioned . To our knowledge, so far only one study , investigating 20 patients with infratentorial infarcts, assessed cognitive function in acute young stroke patients.…”

Feasibility and acceptability of the multicontext approach for individuals with acquired brain injury in acute inpatient rehabilitation: A single case series

“…Further, usual care in rehabilitation tends to be focused on physical impairments and recovery and thus persons with ABI may not have the opportunity to recognize difficulties in higher-level cognitively-based instrumental activities of daily living. This may result in persistent cognitive impairment (Turunen et al, 2018) and negatively impact return to work and other occupations. Conversely, intervening during the acute rehabilitation period can increase the potential of individuals with ABI to return to their everyday activities sooner and at a greater independence level after discharge from the hospital.…”