title: Frequency of domain-specific cognitive impairment in sub-acute and chronic stroke.
abstract: BACKGROUND
  Functional contributions of cognitive impairment may vary by domain and severity.
  
  
  OBJECTIVE
  (1) To characterize frequency of cognitive impairment by domain after stroke by severity (mild: -1.5 ≤ z-score < -2; severe: Z ≤ -2) and time (sub-acute: < 90d; chronic: 90d-2yrs); and (2) To assess the association of cognitive impairment with function in chronic stroke.
  
  
  METHODS
  Cognitive function was characterized among 215 people with sub-acute or chronic stroke (66.8 years, 43.3% female). Z-scores by cognitive domain were determined from normative data. Function was defined as the number of IADLs minimally independent.
  
  
  RESULTS
  76.3% of sub-acute and 67.3% of chronic stroke participants had cognitive impairment in ≥ 1 domain (p-for-difference = 0.09). Severe impairment was most common in psychomotor speed (sub-acute: 53.5%; chronic: 33.7%). Impairment in executive function was common (sub-acute: 39.5%; chronic: 30.7%) but was usually mild. Severe impairment in psychomotor speed, visuospatial function, and language and any impairment in executive function and memory was associated with IADL impairment (p < 0.03).
  
  
  CONCLUSIONS
  Mild cognitive impairment is common after stroke but is not associated with functional disability. Impairment in psychomotor speed, executive function, and visuospatial function is common and associated with functional impairment so should be a focus of screening and rehabilitation post-stroke.
authors.affiliation: Department of Kinesiology, University of Waterloo, Waterloo, Canada Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Research Institute, Toronto, Canada Toronto Rehabilitation Institute, Toronto, Canada.
authors.forename: Laura E
authors.initials: LE
authors.lastname: Middleton
authors.affiliation: Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Research Institute, Toronto, Canada Department of Neurology, Sunnybrook Health Sciences Centre, Toronto, Canada Department of Medicine, University of Toronto, Toronto, Canada.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Lam
authors.affiliation: Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Research Institute, Toronto, Canada Department of Medicine, University of Toronto, Toronto, Canada.
authors.forename: Halla
authors.initials: H
authors.lastname: Fahmi
authors.affiliation: Toronto Rehabilitation Institute, Toronto, Canada Department of Neurology, Sunnybrook Health Sciences Centre, Toronto, Canada Department of Medicine, University of Toronto, Toronto, Canada.
authors.forename: Sandra E
authors.initials: SE
authors.lastname: Black
authors.affiliation: Department of Kinesiology, University of Waterloo, Waterloo, Canada Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Research Institute, Toronto, Canada Toronto Rehabilitation Institute, Toronto, Canada.
authors.forename: William E
authors.initials: WE
authors.lastname: McIlroy
authors.affiliation: Department of Medicine, University of Toronto, Toronto, Canada Department of Psychology, University of Toronto, Toronto, Canada Rotman Research Institute of Baycrest, Toronto, Canada.
authors.forename: Donald T
authors.initials: DT
authors.lastname: Stuss
authors.affiliation: Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Research Institute, Toronto, Canada Toronto Rehabilitation Institute, Toronto, Canada.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Danells
authors.affiliation: Rockwood Epilepsy and Stroke Center, Spokane, WA, USA.
authors.forename: Jon
authors.initials: J
authors.lastname: Ween
authors.affiliation: Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Research Institute, Toronto, Canada Department of Psychology, York University, Toronto, Canada.
authors.forename: Gary R
authors.initials: GR
authors.lastname: Turner
mesh_terms: D000208:Acute Disease; D000368:Aged; D002908:Chronic Disease; D003071:Cognition; D003072:Cognition Disorders / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D003430:Cross-Sectional Studies; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D020521:Stroke / Q000150:complications*