The effect of cognitive impairment on functional outcome after stroke: A cross sectional study

OBJECTIVES: Better functional prognosis of stroke after physical rehabilitation has been established following extensive investigations. However, efficacy of cognitive rehabilitation has not been clearly understood and in order to understand it, a possible association between cognitive and functional status of stroke survivors should be studied. The main objective of this study was to identify a relationship between cognitive impairment and functional outcome in chronic stroke patients. METHODS: Stroke survivors (N=206) were recruited consecutively in a cross sectional study, at least six months after stroke. Using the Barthel Index (BI), patients were divided into two groups of functionally independent (N=146) and dependent (N=60). The Montreal Cognitive Assessment (MoCA) test was used for cognition evaluation and N=15 of patients were cognitively intact and N=191 were cognitively impaired. Statistical analysis was performed to find significant association between MoCA scores and demographic variables including age, gender, marital and job status, years of education, side of lesion and comorbidities and functional dependence. RESULTS: The total MoCA score and all MoCA subtests were significantly related to functional dependence (190.05). The total MoCA score was also an independent predictor of the BI score. It was shown that functional dependent patients were older, with lower years of education and higher numbers of females, housekeepers, and unmarried status. CONCLUSION: The cognitive impairment had a significant impact on functional performance after stroke. Hence, more attention need to be given to cognitive status of patients after stroke in order to accomplish a more efficient rehabilitation and promote functional abilities of stroke survivors.