Apathy, Cognitive Impairment, and Social Support Contribute to Participation in Cognitively Demanding Activities Poststroke.

Chaitali Dagli,Lisa Tabor Connor,Amy Ho,Laura Piccardi,Marjorie L Nicholas

doi:10.1155/2021/8810632

Chaitali Dagli, Lisa Tabor Connor + Show 3 more

Open Access

https://doi.org/10.1155/2021/8810632

Copy DOI

Abstract

Objective To understand the extent to which apathy, cognition, and social support predict participation in activities with cognitive demands. Design Prospective, quantitative correlational, cross-sectional study. Setting. Outpatient treatment centers and community stroke support groups located in St. Louis, MO, and Boston, MA. Participants. 81 community-dwelling individuals ≥ 6-month poststroke with and without aphasia. Measures. Participants completed the Activity Card Sort (ACS), Apathy Evaluation Scale (AES), Medical Outcomes Study Social Support Survey (MOS-SSS), and Delis-Kaplan Executive Function System (DKEFS) Design Fluency and Trail-Making subtests. Results Cognitive deficits limit participation in activities with high cognitive demands. Apathy and positive social interaction influence participation, regardless of high or low cognitive demands. Poststroke aphasia did not impact return to participation in activities with high and low cognitive demands. Conclusions and Relevance. Cognitive deficits seen poststroke contribute to participation only for activities with high cognitive demands. Apathy has a significant and negative influence on participation overall. Social support is a modifiable contextual factor that can facilitate participation. Poststroke apathy can be detrimental to participation but is not well recognized. The availability of companionship from others to enjoy time with can facilitate participation.

Highlights

Stroke is the leading cause of complex disability in the United States with an additional 3.4 million US adults projected to have a stroke by 2030 [1]
There was a positive correlation between cognition scores and percent retained low-CS activities and between Medical Outcomes Study Social Support Survey (MOS-SSS) positive social interaction scores and percent retained low-CS activities, such that higher cognitive ability and greater social support were associated with higher percent retained low-CS activities
40% of the variance in percent retained high-CS activities was explained by apathy, cognitive abilities, and positive social interaction

Summary

Introduction

Stroke is the leading cause of complex disability in the United States with an additional 3.4 million US adults projected to have a stroke by 2030 [1]. Stroke leads to lasting impairments in physical, emotional, cognitive, and language domains [2,3,4] that can negatively impact long-term participation, resumption of meaningful occupations, and quality of life (e.g., [5, 6]). Stroke recovery is synonymous with resuming participation in meaningful prestroke activities and reintegrating into normal living [7]. Over 65% of stroke survivors, report participation restrictions in reintegrating into normal living six months into their recovery. Three-quarters of individuals poststroke do not occupy their day with any meaningful social, leisure, or occupational activities [8]. Participation limitations persist for years after stroke [9, 10]

Objectives

Results

Conclusion