Can the stroke impact scale 3.0 detect cognitive impairments in patients with a recent stroke?
Obaid Almalki, Mansour Abdullah Alshehri, Amir Abdel-Raouf El-Fiky and 4 others
PMID 31417222WHAT IT FOUND
After stroke rehab, 41 older survivors using the Stroke Impact Scale reported trouble with memory, concentration and everyday problem solving, and many reported low mood items.
The scale flagged concerns, but the study did not prove it detects cognitive impairment.
Key findings
01On the Stroke Impact Scale memory and thinking items, 36.6% of participants reported difficulty remembering what people had just told them, and 43.9% reported difficulty solving everyday problems.
02None had a mood and emotions test during admission, and 85.4% reported feeling that life was not worth living and 80.5% reported not smiling or laughing at least once a day.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The study was small and single-site: 50 records were reviewed, 41 met criteria, and all participants were from one city in Ireland. All participants were aged 65 or more, had a first stroke, completed rehabilitation, and attended a follow-up clinic, so the findings do not describe younger patients, recurrent stroke, other neurological disease, or people who did not finish rehabilitation. The Stroke Impact Scale was used only for memory and thinking, mood and emotion, and participation/role function, not for the physical domains. The results section reports descriptive statistics only, so the supplied text does not show how Stroke Impact Scale answers related to MoCA or MMSE results. None of the participants had a mood and emotions test during admission, and 56.1% had not had a memory and thinking test during admission. Some narrative statements about the participation table do not match the table question wording, so the reported participation conclusions are uncertain. The mood and emotion findings are patient-reported answers, not a clinical diagnosis.
Declared interests
No conflicts of interest were declared.
The easy way to misread this
Do not conclude that the Stroke Impact Scale 3.0 detects cognitive impairment. The paper reports patients' answers on selected domains and does not compare those answers with MoCA or MMSE results, so it cannot show that the scale detects impairment.