Cognitive and emotional symptoms in patients with first-ever mild stroke: The syndrome of hidden impairments.
Georgios Vlachos, Hege Ihle-Hansen, Torgeir Bruun Wyller and 4 others
PMID 33145603WHAT IT FOUND
One year after mild stroke, 67% of 117 patients had at least one abnormal cognitive test score and 43% had at least one abnormal emotional score.
Only 18% had no detectable deficit.
Key findings
01In the follow-up sample, only 33% scored within the reference range on all cognitive tests, so 67% scored outside the reference range on at least one cognitive test and might have mild cognitive disorder by the study's criteria.
02At follow-up, 43% had an abnormal score on at least one emotional measure, and fatigue was reported by 33%.
03Only 18% had no detectable cognitive or emotional deficit, while 28% had both.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Pre-stroke cognitive health was inferred from patient, relative, family doctor, or medical record reports, so some patients with mild pre-stroke decline may have been included. The IQCODE screening tool was validated for older people, but it was used here with a cut-off chosen for younger, well-educated patients. Cognitive impairment was defined as at least 1 SD below norms on one test without correction for multiple tests, so mild cognitive disorder may have been overdiagnosed. Only patients who did not have another stroke in the first year were invited to follow-up, so results apply to survivors without recurrent stroke. The sample was mostly men (98 of 127, 77%), and only Norwegian-speaking patients were included.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that mild stroke patients with good daily function have no lasting problems. One year after stroke, 67% scored outside the reference range on at least one cognitive test and 43% on at least one emotional test, although the authors warn that the cognitive cut-off may have overdiagnosed mild impairment.