Recovery in personal care related to cognitive impairment before and after stroke – a 1-year follow-up

Authors

  • M. Cederfeldt,

    1. Institute of Neuroscience and Physiology, Sahlgrenska Academy University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
    2. Vårdalinstitutet, the Swedish Institute for Health Sciences, Gothenburg and Lund, Sweden
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  • G. Gosman-Hedström,

    1. Institute of Neuroscience and Physiology, Sahlgrenska Academy University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
    2. Vårdalinstitutet, the Swedish Institute for Health Sciences, Gothenburg and Lund, Sweden
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  • C. Gutiérrez Pérez,

    1. Institute of Medicine at the Sahlgrenska Academy University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
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  • M. Sävborg,

    1. Institute of Medicine at the Sahlgrenska Academy University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
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  • E. Tarkowski

    1. Institute of Medicine at the Sahlgrenska Academy University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
    2. Department of Medicine, Varberg Hospital, Varberg, Sweden
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Marie Cederfeldt, Institute of Neuroscience and Physiology/Occupational therapy, Sahlgrenska Academy at University of Gothenburg, PO Box 455, SE 405 30 Göteborg, Sweden
Tel.: +46 31 786 5730
Fax: +46 31 786 5723
e-mail: marie.cederfeldt@neuro.gu.se

Abstract

Cederfeldt M, Gosman-Hedström G, Gutiérrez Pérez C, Sävborg M, Tarkowski E. Recovery in personal care related to cognitive impairment before and after stroke – a 1-year follow-up.
Acta Neurol Scand: 2010: 122: 430–437.
© 2010 The Authors Journal compilation © 2010 Blackwell Munksgaard.

Objective –  To examine whether there were any differences in the recovery in performance of personal activities of daily living (P-ADL) in elderly persons in relation to cognitive impairments pre- and post-stroke from discharge to 6 and 12 months in elderly persons.

Methods –  Forty-five elderly persons after stroke were assessed at discharge from hospital and at 6 and at 12 months after stroke onset. A questionnaire posed to the next of kin was used to evaluate the person’s pre- and post-stroke cognitive status. P-ADL was assessed with the Barthel Index. The Mini Mental State Examination and neuropsychological tests were used to measure cognitive functions after stroke. The National Institute of Health Stroke Scale was used to measure neurological deficits.

Results –  Persons with cognitive impairments before and after stroke did not improve in P-ADL from the acute phase until 6 and 12 months, while persons with intact cognition pre- and post-stroke did.

Conclusion –  Since cognitive problems pre- and post-stroke hinder recovery in P-ADL, it is important to understand the connection between cognitive impairment and activity limitations when planning the optimal rehabilitation, which could include special compensation strategies, learnt by the patients, cognitive assistive devices and/or appropriate personal support trained in meaningful activities in daily life in their natural environment.

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