Spontaneous Recovery of Executive Function, Attention, and Processing Speed in Stroke Patients in Colombia.

BACKGROUND: Previous literature has shown disparities between developing and developed regions in executive functioning, attention, and processing speed performance following stroke. Research on post-stroke longitudinal outcomes in Latin America specifically is almost nonexistent. OBJECTIVES: To assess spontaneous recovery among individuals with stroke in the absence of cognitive rehabilitation services in Colombia, South America during the first year post-stroke by comparing their functioning to that of healthy controls across executive functioning, attention, and processing speed at 3, 6, and 12 months. DESIGN: Cohort. SETTING: Stroke rehabilitation center at the regional hospital. PARTICIPANTS: A sample of 50 individuals with stroke and 50 matched healthy controls from Colombia were included in this study. Consistent with the healthcare resources in this region, participants did not receive any inpatient or outpatient cognitive rehabilitation. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Executive functioning, attention, and processing speed. RESULTS: Hierarchical linear models suggested improvements over time for both individuals with stroke and controls, but trajectories of neuropsychological performance were significantly lower for individuals with stroke. Only on one of nine outcomes was there a significant time*group interaction, suggesting greater gains for the stroke group than controls. CONCLUSIONS: These data suggest extremely minor spontaneous recovery among individuals with stroke in Colombia relative to practice effects in controls, and that apparent improvements in executive functioning after stroke were likely just due to practice effects. These findings underscore the bleak outcomes in cognitive functioning after stroke that occur in regions without cognitive rehabilitation.

Health-Related Quality of Life Trajectories over the First Year after Stroke in Colombia, South America.

BACKGROUND Stroke is the second most common cause of death around the world, and little is known about long-term HRQOL outcomes for Latino American individuals after stroke. OBJECTIVE The purpose of the study is to compare HRQOL trajectories in stroke survivors to a group of healthy controls from Colombia first year post-stroke. METHODS Forty individuals diagnosed with stroke and 50 controls were recruited from the Psychological Attention Center of Antonio Nariño University. RESULTS Hierarchical linear models suggested that trajectories of all eight indices of HRQOL were lower over time in stroke individuals compared to controls. Stroke patients showed gains in the HRQOL domains of physical functioning, role limitations - physical, role limitations - emotional, pain, and social functioning, although only pain in stroke individuals approached that of controls at 12 months. Despite these improvements, seven of the eight indices of HRQOL in stroke individuals remained very low over time, suggesting that the vast majority of rehabilitation gains in HRQOL, even when present, were extremely limited. CONCLUSIONS The current findings suggest a need in Latin America for mental health services after stroke, as well as other interventions designed to increase social and family support, which may thereby improve mental health.