Temporal evolution and predictors of subjective cognitive complaints up to 4 years after stroke.
Britta Nijsse, Daan P J Verberne, Johanna M A Visser-Meily and 3 others
PMID 33948672WHAT IT FOUND
In 121 patients with data at all time points, cognitive complaints rose up to 4 years.
At 4 years, 89.3% reported at least one complaint, and the average number was 4.1 on a 0-13 scale. Early complaints and psychological factors were linked to later complaints.
Key findings
01In the 121 patients with complete data, the proportion reporting at least one cognitive complaint was 76.0% at 2 months, 71.9% at 6 months, and 89.3% at 4 years.
02The most often reported complaints were mental slowness, problems doing two things at once, memory problems for new information, and attention problems.
03More cognitive complaints at 2 months were the strongest predictor of more complaints at 4 years. In analyses that considered factors one at a time, lower adaptive psychological scores and higher maladaptive psychological scores were also associated with more complaints at 4 years.
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 main complaint trend used only 121 patients with data at all time points, and 235 of the original 395 patients were lost to follow-up. The patients who stayed in the study were younger and had better MoCA scores than those without complete data, so the complete-case trend may not represent the whole group. There was no demographically matched control group, so the study cannot show how much of the high complaint rate was due to stroke rather than normal ageing or complaints also seen in the general population. Brain imaging was not repeated during long-term follow-up, so new vascular damage could not be ruled out as a reason for increased complaints. The outcome was subjective complaint, not objective cognitive decline, and the authors say the increase was not explained by a parallel increase in MoCA deficits. The multivariate effect of maladaptive psychological scores was difficult to interpret because it changed direction after early complaints were included.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read higher maladaptive psychological scores in the final model as evidence that passive coping or neuroticism reduces long-term complaints. In analyses that considered factors one at a time, maladaptive factors were associated with more complaints, and the reversal appeared only after complaints at 2 months were included in the model.