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Cognition in the first week after stroke: how does it relate to personal and instrumental activities of daily living at follow-up?

Published online by Cambridge University Press:  01 February 2021

Sarah Buys ,
Louise Gustafsson Open the ORCID record for Louise Gustafsson [Opens in a new window] ,
Hannah Gullo ,
Rohan Grimley ,
Mathew Summers  and
Alana Campbell
Sarah Buys
Affiliation:
School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
Louise Gustafsson*
Affiliation:
School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia School of Allied Health Sciences, Griffith University, Brisbane, Australia
Hannah Gullo
Affiliation:
School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
Rohan Grimley
Affiliation:
Sunshine Coast University Hospital, Sunshine Coast, Australia
Mathew Summers
Affiliation:
School of Social Sciences, University of Sunshine Coast, Sunshine Coast, Australia
Alana Campbell
Affiliation:
School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia Sunshine Coast University Hospital, Sunshine Coast, Australia
*
*Corresponding author. Email: louise.gustafsson@griffith.edu.au
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Abstract

Background:

The Montreal Cognitive Assessment (MoCA) is routinely used during the early assessment of people after stroke to indicate cognitive effects and inform clinical decision-making.

Aim:

The purpose of this study was to examine the relationship between cognition in the first week post-stroke and personal and instrumental activities of daily skills at 1 month and 3 months post-stroke.

Method:

A prospective cohort study consecutively recruited people admitted to the acute stroke ward. Acute cognitive status was measured using the MoCA within 1 week post-stroke onset. Functional outcomes were measured using the Functional Independence Measure (FIM) and the Australian Modified Lawton’s Instrumental Activities of Daily Living Scale (Lawton’s) at 1 month and 3 months post-stroke.

Results:

Fifty participants with predominantly mild stroke (n = 47) and mean age of 69.8 achieved a mean MoCA score of 23.1. Controlling for age, the MoCA was associated with the overall FIM score at 1 month (P = 0.02). It was nearing significance for the Lawton’s at 1 month (P = 0.06) but was not associated with either outcome at 3 months. A score of less than 23 on the MoCA was indicative of lower scores on both outcomes.

Conclusions:

A low MoCA score within 1 week of stroke may indicate need for support or rehabilitation due to early impacts on personal activities of daily living, but is not associated with poor functional outcomes at 3 months.

Keywords

self-carecommunity livingmild strokeoccupationfunctional
Type
Original Article
Information
Brain Impairment , Volume 23 , Issue 2 , September 2022 , pp. 185 - 195
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of Australasian Society for the Study of Brain Impairment

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Footnotes

Study performed at the Sunshine Coast University Hospital, Acute Stroke Unit (4A).

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