Early Cognitive and Emotional Outcome After Stroke is Independent of Discharge Destination

Overview

Journal J Neurol

Specialty Neurology

Date 2020 Jun 26

PMID 32583049

Citations 1

Authors

Jos P L Slenders

Daan P J Verberne

Johanna M A Visser-Meily

Renske M Van den Berg-Vos

Vincent I H Kwa

Caroline M van Heugten

Affiliations

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Abstract

Background And Purpose: Cognitive and emotional problems occur frequently after stroke. Patients with minor stroke are more likely to be discharged home. This paper compares early cognitive and emotional outcomes in patients discharged home after stroke versus patients discharged to inpatient rehabilitation, and examines the effect of cognitive and emotional outcomes on long-term participation.

Methods: In this multicenter prospective cohort study, patients with stroke were assessed at two months with the Hospital Anxiety and Depression Scale (HADS), the Checklist for Cognitive and Emotional Consequences following Stroke (CLCE-24) and the Montreal Cognitive Assessment (MoCA). One year post stroke, participation was assessed with the Restriction subscale of the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-P Restriction).

Results: The study included 332 patients. Two months post stroke, anxiety and cognitive problems were equally prevalent among patients discharged home (n = 243; 73%) and patients discharged to inpatient rehabilitation (n = 89; 27%) (HADS-A = 4.8 ± 3.9 versus 4.6 ± 4.0, p = 0.747; MoCA < 26: 66.7% versus 70.8%, p = 0.477; CLCE-cognition = 3.0 ± 2.9 versus 3.3 ± 2.8, p = 0.499). Depressive symptoms were less severe in patients discharged home (HADS-D = 4.3 ± 3.9 versus 5.5 ± 3.8, p = 0.010). In patients discharged home, cognitive complaints were predictive of long-term participation (B = - 2.03; 95% CI - 3.15, - 0.90), while cognitive or emotional outcomes were not predictive in patients discharged to inpatient rehabilitation.

Conclusions: Cognitive and emotional problems at two months post stroke were comparable between patients discharged home and those discharged to inpatient rehabilitation. For patients discharged home, cognitive complaints were predictive of long-term participation.

Citing Articles

Screening and care for emotional and cognitive problems after stroke: a prospective mixed-methods process evaluation of a cluster-randomized controlled trial.

Slenders J, Visser-Meily J, Kwa V, Van den Berg-Vos R, Sommers-Spijkerman M, Van Heugten C BMC Health Serv Res. 2025; 25(1):337.

PMID: 40038655 PMC: 11881483. DOI: 10.1186/s12913-025-12470-w.

Prevalence, Trajectory, and Factors Associated With Patient-Reported Nonmotor Outcomes After Stroke: A Systematic Review and Meta-Analysis.

Ozkan H, Ambler G, Esmail T, Banerjee G, Simister R, Werring D JAMA Netw Open. 2025; 8(2):e2457447.

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Memory rehabilitation: restorative, specific knowledge acquisition, compensatory, and holistic approaches.

Gopi Y, Wilding E, Madan C Cogn Process. 2022; 23(4):537-557.

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