title: The importance of cognition to quality of life after stroke.
abstract: OBJECTIVE
  Suffering a stroke typically has a negative impact on a person's quality of life. There is some evidence that post-stroke cognitive impairment is associated with poor quality of life, but the relative importance of deficits in different cognitive domains has not been established.
  
  
  METHODS
  Patients with confirmed stroke were recruited in the acute hospital. A subgroup of patients completed 2 computerized cognitive tasks (simple and choice reaction time) within 2 weeks of stroke. The full cohort was followed up at 3 months with a comprehensive neuropsychological battery and then at 12 months with the Assessment of Quality of Life ('AQoL).
  
  
  RESULTS
  Sixty patients participated in the study (mean age 72.1 years, SD 13.9), with a subgroup of 33 patients tested acutely (mean age 75.5 years, SD 11.9). Presence of cognitive impairment at 3 months was independently associated with lower quality of life at 12 months (p=0.021). Attention and visuospatial ability were the cognitive domains most closely associated with quality of life. Faster choice reaction time in the acute stage (mean 5.4 days post-stroke) was significantly associated with better quality of life at 12 months (p=0.003).
  
  
  CONCLUSIONS
  Cognition, particularly attention and visuospatial ability, is strongly associated with quality of life after stroke. It is possible that straightforward reaction time tasks are sensitive to the extent of brain damage, and might therefore be surrogate markers for quality of life.
authors.affiliation: Stroke Division, Florey Institute of Neuroscience and Mental Health, Melbourne, 3084, Australia; Department of Florey, University of Melbourne, Melbourne, 3084, Australia. Electronic address: toby.cumming@florey.edu.au.
authors.forename: Toby B
authors.initials: TB
authors.lastname: Cumming
authors.affiliation: Stroke Division, Florey Institute of Neuroscience and Mental Health, Melbourne, 3084, Australia; Behavioural Neuroscience Division, Florey Institute of Neuroscience and Mental Health, Melbourne, 3084, Australia; Department of Florey, University of Melbourne, Melbourne, 3084, Australia.
authors.forename: Amy
authors.initials: A
authors.lastname: Brodtmann
authors.affiliation: Behavioural Neuroscience Division, Florey Institute of Neuroscience and Mental Health, Melbourne, 3084, Australia; Department of Florey, University of Melbourne, Melbourne, 3084, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Darby
authors.affiliation: Stroke Division, Florey Institute of Neuroscience and Mental Health, Melbourne, 3084, Australia; Department of Florey, University of Melbourne, Melbourne, 3084, Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Bernhardt
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001288:Attention; D003071:Cognition; D060825:Cognitive Dysfunction / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011788:Quality of Life; D011930:Reaction Time; D020521:Stroke / Q000523:psychology*
keywords: Attention; Cerebrovascular disease; Cognitive impairment; Neuropsychology; Quality of life; Reaction time