Intraindividual variability in post-stroke cognition and its relationship with activities of daily living and social functioning: an ecological momentary assessment approach.

The study did not assign participants to treatments or follow them after an intervention, so it can show association but not cause. The high variability class had only 14 participants, which may have reduced power to detect differences in neuropsychological and functional outcomes. The sample was community-dwelling and had mild-to-moderate stroke, so it may not apply to acute stroke or more severe disability. Cognitive variability was measured with only two self-report questions, which may not capture all aspects of cognition. Standardized neuropsychological tests were designed to measure overall cognitive capacity, not day-to-day variability, so a mismatch between self-report and testing is expected. Self-reported cognitive variability may be influenced by environment, pain, fatigue, depression, or stress, but the study did not test these factors. Ten participants were excluded for completing less than 30% of surveys and 14 dropped out before completion, so the analysed group may differ from those who did not complete the protocol.

No conflicts of interest statement is included in the supplied text. The article metadata lists NIH extramural and non-U.S. government research support.

Do not read this paper as proof that cognitive variability causes worse daily living or social functioning, or that ecological momentary assessment screening will improve outcomes. The study did not assign participants to treatments or test an intervention, and the high variability group had only 14 participants, so the findings describe differences between groups, not treatment effects.