A prospective cohort study on longitudinal trajectories of cognitive function after stroke

Area of Science:

• Neurology
• Cognitive Science
• Rehabilitation Medicine

Background:

• Stroke is a leading cause of long-term disability, often resulting in cognitive impairment.
• Understanding cognitive recovery patterns post-stroke is crucial for effective patient management.
• Longitudinal data on cognitive trajectories in the first year after stroke is limited.

Purpose of the Study:

• To identify distinct longitudinal trajectories of cognitive function in the first year post-stroke.
• To characterize patient groups based on their cognitive recovery patterns.
• To explore the relationship between cognitive trajectories and specific deficits, such as memory problems.

Main Methods:

• Utilized group-based trajectory modeling to analyze cognitive function data from 94 stroke patients.
• Assessed cognitive function using the Montreal Cognitive Assessment (MoCA) at 36-48 hours, 3 months, and 12 months post-stroke.
• Compared patient MoCA scores to normative data after matching for age, sex, and education.

Main Results:

• Identified three distinct cognitive functioning groups: high (15%), medium (62%), and low (23%).
• Cognitive function improved by 12 months in the high and medium groups, but not in the low group.
• 55% of patients were cognitively impaired at baseline, with minimal recovery observed by 12 months. The low cognitive function group experienced severe memory problems.

Conclusions:

• A substantial proportion of stroke survivors, particularly those with initially low cognitive function, do not recover within the first year.
• The low-functioning group faces significant memory impairments, underscoring the need for specialized, long-term rehabilitation strategies.
• Findings support the development of personalized rehabilitation plans to address the specific needs and daily living challenges of stroke survivors with persistent cognitive deficits.