title: The role of objective cognitive dysfunction in subjective cognitive complaints after stroke.
abstract: Objective cognitive performance (OCP) is often impaired in patients post-stroke but the consequences of OCP for patient-reported subjective cognitive complaints (SCC) are poorly understood. We performed a detailed analysis on the association between post-stroke OCP and SCC.
  
  
  
  Assessments of OCP and SCC were obtained in 208 patients 3 months after stroke. OCP was evaluated using conventional and ecologically valid neuropsychological tests. Levels of SCC were measured using the CheckList for Cognitive and Emotional (CLCE) consequences following stroke inventory. Multivariate hierarchical regression analyses were used to evaluate the association of OCP with CLCE scores adjusting for age, sex and intelligence quotient. Analyses were performed to examine the global extent of OCP dysfunction (based on the total number of impaired neuropsychological tests, i.e. objective cognitive impairment index) and for each OCP test separately using the raw neuropsychological (sub)test scores.
  
  
  
  The objective cognitive impairment index for global OCP was positively correlated with the CLCE score (Spearman's rho = 0.22, P = 0.003), which remained significant in multivariate adjusted models (β = 0.25, P = 0.01). Results for the separate neuropsychological tests indicated that only one task (the ecologically valid Rivermead Behavioural Memory Test) was independently associated with the CLCE in multivariate adjusted models (β = -0.34, P < 0.001).
  
  
  
  Objective neuropsychological test performance, as measured by the global dysfunction index or an ecologically valid memory task, was associated with SCC. These data suggest that cumulative deficits in multiple cognitive domains contribute to subjectively experienced poor cognitive abilities in daily life in patients post-stroke.
authors.affiliation: Centre of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands.|Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands.
authors.forename: M W A
authors.initials: MW
authors.lastname: van Rijsbergen
authors.affiliation: Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands.
authors.forename: R E
authors.initials: RE
authors.lastname: Mark
authors.affiliation: Centre of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands.|Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
authors.forename: W J
authors.initials: WJ
authors.lastname: Kop
authors.affiliation: Department of Neurology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands.
authors.forename: P L M
authors.initials: PL
authors.lastname: de Kort
authors.affiliation: Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands.
authors.forename: M M
authors.initials: MM
authors.lastname: Sitskoorn
mesh_terms: D000368:Aged; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology*; D060825:Cognitive Dysfunction / Q000209:etiology / Q000523:psychology*; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000209:etiology / Q000523:psychology; D008875:Middle Aged; D009483:Neuropsychological Tests; D011597:Psychomotor Performance; D020521:Stroke / Q000150:complications / Q000523:psychology*
keywords: cognitive complaints; neuropsychological tests; objective performance; self-report; stroke