Cognitive impairment is a frequent but often under-recognized complication after stroke, contributing substantially to long-term disability worldwide. Despite its clinical relevance, the actual prevalence of stroke-related cognitive dysfunction remains unknown. We aimed to assess the self-perceived prevalence of cognitive impairment among stroke survivors using a simple structured follow-up tool.: Consecutive ischemic stroke patients enrolled in the TRUSTROKE (Trustworthy AI for improvement of stroke Outcomes) European-granted project were included after acute hospitalization. Patients discharged home or to a rehabilitation center were followed up by an occupational therapist/physiotherapist acting as case manager through a communication tool based on a smartphone app or phone calls (NORA, Figure 1). A substudy was conducted across three participating hospitals focusing on cognitive complications identified through the Post-Stroke Checklist (PSC). Over an 8-month period, 233 out of 420 patients completed the PSC at <70 days post-discharge. Figure 2 shows patients reporting cognitive complaints and whether these interfere with daily activities, and its correlation with anxiety-depression symptoms. Besides, in Hospital 1, the subgroup of patients with cognitive complaints compared with the overall series, showed a higher degree of stroke severity (median NIHSS 2) and functional disability at discharge (median mRS 2), and transfer to rehabilitation centers was more frequent (p<0.0005). No differences on sex or age were detected. Importantly, the presence of anxious–depressive symptoms was strongly associated with cognitive impairment interfering with daily life in this group of patients (p<0.001). One-third of stroke survivors reported self-perceived cognitive impairment within the first two months after discharge, with one in five experiencing limitations in daily activities. Cognitive dysfunction was associated with greater disability, higher rehabilitation needs, and comorbid mood symptoms. The PSC proved to be a feasible first-line tool for detecting cognitive complications in routine follow-up. Early identification through PSC may guide healthcare professionals in selecting patients for further neurocognitive assessment and targeted cognitive rehabilitation, ultimately promoting autonomy and participation in daily living.:
Guirao et al. (Thu,) studied this question.
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