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Updated: May 29, 2026

Dual-Task Stroop Paradigm for Detecting Cognitive Deficits in High-Functioning Stroke Patients
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Performance-based everyday functioning after stroke: relationship with IADL questionnaire and neurocognitive

Joseph R Sadek1, Nikki Stricker, John C Adair

  • 1New Mexico VA Health Care System, Albuquerque, New Mexico. jsadek@unm.edu

Journal of the International Neuropsychological Society : JINS
|September 2, 2011
PubMed
Summary
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The Functional Impact Assessment (FIA) effectively measures daily functioning in stroke patients. This performance-based tool shows strong links to cognitive abilities, outperforming questionnaires in predicting daily living impairments.

Area of Science:

  • Neuropsychology
  • Rehabilitation Medicine
  • Clinical Psychology

Background:

  • Assessing everyday functioning is crucial for neuropsychologists, but current methods often rely on subjective questionnaires.
  • Performance-based assessments offer objective insights into daily living skills but lack comprehensive, validated measures.
  • Stroke survivors frequently experience deficits in daily functioning, necessitating reliable assessment tools.

Purpose of the Study:

  • To introduce and validate the Functional Impact Assessment (FIA), a performance-based battery for daily living skills.
  • To compare the FIA's effectiveness against the Functional Activities Questionnaire (FAQ) in stroke patients.
  • To examine the relationship between the FIA and cognitive functioning assessed by the Neuropsychological Assessment Battery (NAB).

Main Methods:

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  • The Functional Impact Assessment (FIA) was administered to 47 unilateral stroke patients and 37 healthy controls.
  • The FIA was validated against self- and informant-report versions of the Functional Activities Questionnaire (FAQ).
  • Relationships between the FIA and cognitive performance (NAB) were analyzed in the stroke group.

Main Results:

  • Stroke patients performed significantly worse than controls on the FIA, FAQ, and NAB.
  • The NAB total score strongly correlated with FIA performance (r = .83) and was a better predictor of impairment than the informant FAQ.
  • A NAB total scaled score below 86 accurately identified FIA impairment (92% sensitivity, 84% specificity).

Conclusions:

  • The Functional Impact Assessment (FIA) is a sensitive and valid measure of daily functioning deficits in stroke patients.
  • FIA performance is strongly associated with broad cognitive domains, including attention, executive functions, language, spatial skills, and memory.
  • The FIA, combined with NAB cognitive data, provides a robust approach to assessing functional impact after stroke.