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Cognitive Testing During Mild Acute Ischemic Stroke Predicts Long-Term Return to Work.

Sabreena J Slavin1, Lindsay McCune-Richardson2, Justin Moore3

  • 1Department of Neurology, University of Kansas Medical Center, 3901 Rainbow Blvd, MS 2012, KS 66207, USA.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|October 27, 2021
PubMed
Summary
This summary is machine-generated.

Early cognitive tests like the Clock Drawing Test (CDT) and Montreal Cognitive Assessment (MOCA) after ischemic stroke can predict return to work and driving. These assessments aid in prognosis and identifying patients needing interventions.

Keywords:
Acute ischemic strokeCognitive testingMild strokeOutcomes

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Area of Science:

  • Neurology
  • Neuropsychology
  • Rehabilitation Medicine

Background:

  • Mild ischemic stroke survivors often face challenges returning to work and driving.
  • Cognitive impairment is a common long-term consequence of stroke.
  • Assessing cognitive function during the acute phase may predict functional outcomes.

Purpose of the Study:

  • To investigate if acute inpatient cognitive testing predicts workforce reengagement and functional recovery after ischemic stroke.
  • To evaluate the predictive value of specific cognitive tests for return to work and driving.

Main Methods:

  • Prospective enrollment of working adults (<65 years) with first-ever ischemic stroke (mRS ≤1, NIHSS ≤3).
  • Administered cognitive tests (MOCA, CDT, Trail Making A/B, Backward Digit Span) and anxiety/depression scales (HADS) within one week of stroke.
  • Assessed return to work, driving, and modified Rankin Scale (mRS) at 3, 6, and 12 months using logistic regression analysis.

Main Results:

  • Of 39 patients, 58% returned to work and 78% to driving by 3 months.
  • Each point increase in CDT score significantly increased odds of return to work (3.79x) and driving (6.74x) at 3 months.
  • MOCA and HADS correlated with mRS ≤1; MOCA predicted return to work at 6 months, CDT at 12 months.

Conclusions:

  • Acute cognitive assessments, specifically CDT and MOCA, show potential in predicting post-stroke return to work, driving, and independence.
  • These tests can serve as prognostic tools for identifying stroke survivors who may benefit from targeted interventions.