The Impact of Cognitive Impairment on Poststroke Outcomes: A 5-Year Follow-Up.

ABSTRACT

AIM: To explore the impact of cognitive impairment poststroke on outcomes at 5 years. METHODS: Five-year follow-up of the Action on Secondary Prevention Interventions and Rehabilitation in Stroke (ASPIRE-S) prospective cohort. Two hundred twenty-six ischemic stroke survivors completed Montreal Cognitive Assessments at 6 months poststroke. Outcomes at 5 years included independence in activities of daily living, receipt of informal care, quality of life, and depressive symptoms. Data were analyzed using logistic and linear regression models. Adjusted odds ratios (ORs; 95% confidence interval [CI]) and ß coefficients (95% CI) are reported. RESULTS: One hundred one stroke survivors were followed up at 5 years. Cognitive impairment at 6 months was independently associated with worse quality of life (B [95% CI] -0.595 [-0.943 to -0.248]), lower levels of independence (B [95% CI] -3.605 [-5.705 to -1.505]), increased likelihood of receiving informal care (OR [95% CI] 6.41 [1.50-27.32]), and increased likelihood of depressive symptoms (OR [95% CI] 4.60 [1.22-17.40]). Conclusion: Cognitive impairment poststroke is associated with a range of worse outcomes. More effective interventions are needed to improve outcomes for this vulnerable group of patients.