Recovery in personal care related to cognitive impairment before and after stroke - a 1-year follow-up.
OBJECTIVE
To examine whether there were any differences in the recovery in performance of personal activities of daily living (P-ADL) in elderly persons in relation to cognitive impairments pre- and post-stroke from discharge to 6 and 12 months in elderly persons.


METHODS
Forty-five elderly persons after stroke were assessed at discharge from hospital and at 6 and at 12 months after stroke onset. A questionnaire posed to the next of kin was used to evaluate the person's pre- and post-stroke cognitive status. P-ADL was assessed with the Barthel Index. The Mini Mental State Examination and neuropsychological tests were used to measure cognitive functions after stroke. The National Institute of Health Stroke Scale was used to measure neurological deficits.


RESULTS
Persons with cognitive impairments before and after stroke did not improve in P-ADL from the acute phase until 6 and 12 months, while persons with intact cognition pre- and post-stroke did.


CONCLUSIONS
Since cognitive problems pre- and post-stroke hinder recovery in P-ADL, it is important to understand the connection between cognitive impairment and activity limitations when planning the optimal rehabilitation, which could include special compensation strategies, learnt by the patients, cognitive assistive devices and/or appropriate personal support trained in meaningful activities in daily life in their natural environment.
Cederfeldt
Marie
M
Institute of Neuroscience and Physiology/Occupational therapy, Sahlgrenska Academy University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden. marie.cederfeldt@neuro.gu.se
Gosman-Hedström
G
G
Pérez
C Gutiérrez
CG
Sävborg
M
M
Tarkowski
E
E
D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D001288:Attention / Q000502:physiology; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology / Q000534:rehabilitation; D056344:Executive Function / Q000502:physiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008568:Memory / Q000502:physiology; D008609:Mental Status Schedule; D009483:Neuropsychological Tests; D020127:Recovery of Function / Q000502:physiology*; D020521:Stroke / Q000150:complications*; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D013997:Time Factors