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Conceptualizing functional cognition in stroke.

Neila J Donovan1, Diane L Kendall, Shelley C Heaton

  • 1VA HSR&D/RR&D Rehabilitation Outcomes Research Center, Gainesville, FL 32608, USA. neilad@phhp.ufl.edu

Neurorehabilitation and Neural Repair
|September 1, 2007
PubMed
Summary
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This study established key functional cognition domains for stroke survivors, crucial for developing a new computer adaptive measure to improve cognitive assessment after stroke.

Area of Science:

  • Neurology
  • Neuropsychology
  • Clinical Trials
  • Epidemiology

Background:

  • Post-stroke cognitive impairments affect up to 65% of individuals, increasing healthcare costs and caregiver burden.
  • Current stroke clinical trials primarily focus on physical recovery, neglecting cognitive deficits.
  • Existing neuropsychological assessments have limited utility in clinical trials, highlighting the need for better functional cognition measures.

Framework:

  • The study aimed to define functional cognition domains essential for a computer adaptive measure tailored for stroke patients.
  • Domains were identified through literature review and expert consensus from neurology, neuropsychology, aphasiology, clinical trials, and epidemiology.

Implementation:

  • Initially, 17 domains were proposed, including various aspects of language, visuospatial function, memory, and executive functions.

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  • An expert advisory panel refined the list, recommending specific modifications and additions like limb apraxia and post-stroke depression.
  • The final 10 domains encompass language, reading/writing, calculation, limb praxis, visuospatial function, social language use, emotional function, attention, executive function, and memory.
  • Implications:

    • Establishing these domains is a critical first step towards developing a computer adaptive test for functional cognition in stroke survivors.
    • Further development involves item creation, psychometric analysis, and programming for a computer adaptive test.
    • This measure has the potential to significantly enhance cognitive assessment and management in post-stroke care.