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Real-Time Associations Between Subjective Cognitive Concerns and Daily Activity Participation in Persons Aging With
Jiali He1,2, Quoc Bui3, Mandy W M Fong1,4
1Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
JMIR Aging
|July 14, 2026
Summary
Subjective cognitive concerns (SCCs) in stroke survivors decrease with daily activities like ADLs and social engagement. Engaging in these activities may help reduce cognitive issues and inform rehabilitation strategies.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Gerontology
Background:
- Stroke is a primary cause of disability in aging populations, with cognitive impairments significantly impacting quality of life.
- Subjective cognitive concerns (SCCs) are recognized predictors of dementia and vital indicators for post-stroke rehabilitation.
- Smartphone-based ecological momentary assessment (EMA) offers a method to study SCCs in real-world settings for individuals aging with stroke.
Purpose of the Study:
- To investigate real-time associations between subjective cognitive concerns (SCCs) and daily activity participation in individuals aging with stroke using EMA.
- To understand how cognitive concerns fluctuate with different types of daily activities and social contexts.
- To inform the development of targeted cognitive rehabilitation and prevention strategies for stroke survivors.
Main Methods:
- A longitudinal observational study utilizing smartphone-based EMA for real-time data collection over two weeks.
- Participants completed surveys five times daily assessing SCCs (concentration, learning) and daily activity participation (location, company, activity type, self-appraisals).
- Multilevel models were employed to analyze the complex relationships between cognitive concerns and activity engagement.
Main Results:
- SCCs were lower during activities of daily living (ADL), instrumental ADL, cognitively stimulating, and social activities.
- Lower SCCs were also observed when participants were with family, friends, or partners, and in social locations like a friend's home.
- Conversely, SCCs were higher in hospital settings and associated with poorer self-ratings of performance, satisfaction, and engagement.
Conclusions:
- EMA effectively captures the interplay between post-stroke cognition and daily activity participation.
- Engaging in ADLs, instrumental ADLs, cognitively demanding, and social activities may alleviate cognitive concerns in stroke survivors.
- These findings support the integration of specific activities into rehabilitation plans and highlight the potential for interventions to enhance both cognition and activity participation.
