Auckland stroke outcomes study part 2: Cognition and functional outcomes 5 years poststroke

Barker-Collo, S., Feigin, V. L., Parag, V., Lawes, C. M. M. and Senior, H. (2010) Auckland stroke outcomes study part 2: Cognition and functional outcomes 5 years poststroke. Neurology, 75 18: 1608-1616. doi:10.1212/WNL.0b013e3181fb44c8

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Author Barker-Collo, S.
Feigin, V. L.
Parag, V.
Lawes, C. M. M.
Senior, H.
Title Auckland stroke outcomes study part 2: Cognition and functional outcomes 5 years poststroke
Journal name Neurology   Check publisher's open access policy
ISSN 0028-3878
1526-632X
1666-5791
Publication date 2010-11
Sub-type Article (original research)
DOI 10.1212/WNL.0b013e3181fb44c8
Volume 75
Issue 18
Start page 1608
End page 1616
Total pages 9
Place of publication Philadelphia, United States
Publisher Lippincott Williams & Wilkins
Collection year 2011
Language eng
Formatted abstract
Background: Understanding the extent of long-term neuropsychological deficits poststroke and their contribution to functional outcomes is essential for evidence-based rehabilitation and resource planning, and could improve stroke outcomes. However, most existing neuropsychological stroke data are not population-based, examine limited outcomes, and have short-term follow-up.
Methods: This population-based long-term stroke follow-up study examined associations between neuropsychological deficits (memory, executive function, information processing speed [IPS], visuoperceptual/construction ability, language), depression, and a range of functional outcomes and their interrelationships 5 years poststroke.
Results: The greatest proportion of the 307 participants exhibited neuropsychological functioning within the average range, and about 30%-50% performed at lower levels on most measures; few performed above the average range. Deficits were most common in executive functioning and IPS, and 30.4% of participants were depressed. While correlation analyses indicate all cognitive domains are significantly related to functional outcomes, multiple regression analyses showed that only IPS and visuoperceptual ability made significant independent contributions to functional outcomes over and above age, depression, and current Barthel Index. Depression also made a significant and independent contribution to functional outcomes.
Conclusion:
A considerable proportion of 5-year stroke survivors experience neuropsychological deficits, with these being more likely to involve IPS and executive functioning. Visuoperceptual/construction abilities, visual memory, and IPS were independently associated with handicap, disability, and health-related quality of life over and above contributions made by age, depression, and stroke severity, suggesting these areas are important targets for rehabilitation to improve overall stroke recovery and should be evaluated in future randomized controlled trials. Copyright © 2010 by AAN Enterprises, Inc.

Keyword Ischemic stroke
New Zealand
Clinical determinants
Follow-up
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Medicine Publications
 
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Created: Sun, 05 Dec 2010, 00:03:57 EST