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, Marcel W.M. Post, Paul L.M. de Kort, Caroline M. van Heugten
Neurology, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands.
Objective: To examine the temporal evolution of subjective cognitive complaints in the long-term after stroke, and to identify predictors of long-term subjective cognitive complaints.
Methods: Prospective cohort study including 395 stroke patients. Subjective cognitive complaints were assessed at 2 months, 6 months and 4 years post-stroke, using the Checklist for Cognitive and Emotional consequences following stroke (CLCE-24). The temporal evolution of subjective cognitive complaints was described using multilevel growth modelling. Associations between CLCE-24 cognition score at 4 years post-stroke and baseline characteristics, depression, anxiety, cognitive test performance, and adaptive and maladaptive psychological factors were examined. Significant predictors were entered in a multivariate multilevel model. Results: A significant increase in subjective cognitive complaints from 2 months up to 4 years (mean 3. 7 years, standard deviation (SD) 0. 6 years) post-stroke was observed (p≤0. 001). Two months post-stroke, 76% of patients reported at least one cognitive complaint, 72% at 6 months, and 89% at 4 years post-stroke. A higher level of subjective cognitive complaints at 2 months and lower scores on adaptive and maladaptive psychological factors were significant independent predictors of a higher level of subjective cognitive complaints at 4 years post-stroke.
Conclusion: Post-stroke subjective cognitive complaints increase over time and can be predicted by the extent of subjective cognitive complaints and the presence of adaptive and maladaptive psychological factors in the early phases after stroke.
Many people suffer a stroke in the brain leading to consequences in different areas of functioning. Complaints in the domain of thinking (memory, attention, planning and organization) are frequent post-stroke. This study investigated the occurrence and type of complaints experienced in the first years after a stroke. The study found that these complaints increase over time. Long-term complaints are found in those people who already have problems early after stroke.
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