Prediction of post-stroke functional mobility from the initial assessment of cognitive function

Cognitive impairment is frequently seen in patients with stroke. The possible correlation between cognitive function and functional mobility has been proposed; however, the prognostic importance of early cognitive function in recovery of mobility has not been investigated in patients with stroke.

The objective of this study is to investigate whether the cognitive function in the acute phase can independently predict the recovery of mobility after stroke, and to determine the cut-off value of each cognitive evaluation test for community ambulation at six months.

Seventy two patients underwent four domain-specific neuropsychological evaluation tests at about two weeks after stroke; these included the word list memory test (WMT), construction praxis test (CPT), verbal fluency test (VFT) and Boston naming test (BNT). The Functional Ambulation Category (FAC) and ambulatory zone (AZ) at six months after stroke were investigated as outcome variables. The domain-specific cognitive function, along with other possible predictors for functional mobility, was analyzed with regression analysis.

The z-scores of WMT (p = 0.018) and VFT (p = 0.012) were related to the independence in ambulation. The z-scores of VFT (p = 0.006) and CPT (p = 0.009) were predictors for community ambulation, with the cut-off values of -2.215 for VFT, and of -0.845 for CPT.

Cognitive impairment in the acute phase of stroke can be an independent prognostic factor of functional mobility. Domain-specific neuropsychological evaluation tests should be considered in the acute phase of stroke to predict the recovery of functional mobility.