Abstract TP15: Self-report Does Not Align With Objective Assessments Of Memory And Fine Motor Functioning In Stroke Survivors

Abstract

Introduction: Stroke increases the risk of cognitive and motor impairment long after the subacute recovery period. Clinicians often rely on patients to self-report symptoms, though this may not always align with objective findings. The aim of this study was to determine the associations between self-report and objective methods of evaluation when examining cognitive and motor functioning in stroke survivors. Methods: Seventy ischemic stroke participants over age 45 completed the Hopkins Verbal Learning Test-Revised (HVLT) and the Finger Tapping Test (FTT) 5-13 months post-stroke as part of the StrokeCog study. Performance of at least one standard deviation below the normative mean was considered abnormal. Self-report ratings in memory and thinking, hand function, and depression were assessed with the Stroke Impact Scale (SIS) as well as fatigue (FACIT) and stroke severity (NIHSS). Logistic regression was used to assess associations with HVLT and FTT performance as dependent factors. Results: Thirty-nine percent of participants demonstrated abnormal memory performance on the HVLT. The normal and abnormal memory groups did not differ in self-reported memory (p = 0.242) or depression (p = 0.232). A trend towards less stroke severity among patients with normal (median (IQR) NIHSS 2 (1-8)) vs. impaired memory exists (NIHSS 6 (2-12.5); p = 0.08). Less fatigue (OR (95% CI) 1.05 [1.001-1.11]) and female sex (OR 3.80 [1.09-13.21]) were independently associated with normal memory. Fifty-two percent of participants demonstrated abnormal motor performance on the FTT. The normal and abnormal motor groups did not differ in self-reported hand function (p = 0.285). Male sex (OR 19.6 [3.8-100]) and lower depression (OR 1.12 [1.05 - 1.20]) were independently associated with normal motor function. Conclusion: Self-report did not align with objective assessments of memory and fine motor functioning in stroke survivors. Fatigue and male sex were associated with memory impairment while depression and female sex were associated with motor impairment. This highlights the role of fatigue and depression in long-term stroke outcomes and the importance of using both objective and subjective methods when evaluating cognitive and motor impairment.