Domain-specific Cognitive Impairments, Mood and Quality of Life 6 Months After Stroke

Purpose To identify which acute and 6-month domain-specific cognitive impairments impact mood functioning, participation, and stroke-related quality of life 6 months after stroke. Materials and Methods A prospective cohort of 430 stroke survivors completed the Oxford Cognitive Screen (OCS) acutely and 6 months post-stroke. Participants completed the Stroke Impact Scale (SIS) and Hospital Depression and Anxiety Scale (HADS) at 6 months. Multivariable regression analyses assessed whether severity of, and domain-specific, cognitive impairment acutely and at 6 months was associated with composite 6-month SIS scores, each SIS subscale, and HADS scores. Results Increased severity of cognitive impairment acutely and at 6 months was associated with lower 6-month SIS composite scores independent of age, sex, education years, and stroke severity (both p<0.001). Domain-specific impairments in memory (p<0.001) and attention (p=0.002) acutely, and language (p<0.001), memory (p=0.001) and number processing (p=0.006) at 6 months showed the strongest associations with worse SIS composite scores. Severity of acute and 6-month cognitive impairment was associated with poorer functioning in each SIS subscale, as well as greater levels of depression (acute p=0.021, 6-months p<0.001), but not anxiety (p=0.174, p=0.129). Conclusions Both acute and 6-month domain-specific cognitive impairments, particularly in memory, were found to negatively impact overall functional and mood outcomes 6 months post-stroke.