TITLE:
Impaired Cognition and Stroke Rehabilitation Outcomes: Are They Related?
AUTHORS:
Eric F. Tanlaka, Torri Trojand
KEYWORDS:
Stroke, Impaired Cognition, Inpatient Rehabilitation, Functional Outcomes
JOURNAL NAME:
Open Journal of Therapy and Rehabilitation,
Vol.12 No.2,
March
27,
2024
ABSTRACT: Background: Stroke survivors who exhibit impaired cognition at admission to
inpatient rehabilitation may experience participation challenges and poorer
functional outcomes than those without impaired cognition. Differences in
functional outcomes between stroke survivors with and without impaired
cognition may be attributed to age, level of cognitive impairment, and severity
of stroke. Materials and Methods: A retrospective secondary data
analysis was conducted using health-related administrative data acquired from a
Southwestern Ontario hospital’s stroke rehabilitation database. The aim was to
explore potential linkages between post-stroke impaired cognition and
functional gains, rehabilitation stays, and living settings after discharge
from rehabilitation. Results: An aggregate sample of 393 males and 314
females subclassified as experiencing mild, moderate, and severe stroke was
analyzed. At inpatient rehabilitation admission, 21.5% (n = 152) of these
patients had no impaired cognition, 33.7% (n = 238) had mild impaired
cognition, 22.2% (n = 157) had moderate impaired cognition, and 22.6% (n = 160)
had severe impaired cognition. Cognitively impaired stroke patients were
significantly (p 0.001) older, had (mostly)
moderate to severe stroke with significantly (p = 0.012) more moderate
cognitive impairment, had significantly (p 0.001)
longer rehabilitation stays, and a high propensity for being discharged to
longer-term care facilities compared to non-cognitively impaired patients. Conclusion: Presence of significant dissimilarity in rehabilitation stays and
post-discharge destinations among stroke survivors with and without cognitive
impairment is attributed to the age of the patient, level of cognitive
impairment, and rigorous rehabilitation interventions.