Descriptive study of post-minor stroke cognitive defects (modified ranking scale ≤ 2), impact on quality of life and return to work

Abstract

descriptive study of cognitive impairments in patients having presented a right-sided, left-sided or bilateral minor stroke (modified ranking scale ≤ 2), and evaluation of their impact on life quality and return to work. This study includes 47 patients having presented a minor stroke. Cognitive functions were evaluated in day hospital by neuropsychologists, ergotherapists and speech-therapists. These assessments were conducted between 6 and 24 months after the stroke, with evaluations of the patients’ executive functions, short- and long-term memory and information processing speed. The defects’ impact on everyday life was calculated with the MacNair and Kahn scale, the Reintegration to Normal Living Index (RNLI) and the Sickness Impact Profile-65 (SIP-65). Correlations between cognitive performances and everyday impacts were made. On the professional level, 73% of patients working before the stroke had not resumed their professional activity at the time of their evaluation. No patient having presented a left-sided stroke returned to full-time work. Regarding life quality, scores showed no significant difference comparable between the three groups. In the cohort, the RNLI averaged at 78.5%, the SIP-65 at 0.32, and the MacNair at 58.4/156. Concerning neuropsychological tests, the Montreal cognitive assessment (MOCA) score was < 26 for 54.6% of the patients, with a significant difference between the groups of bilateral and right-sided strokes, in favour of the latter. There was no significant difference between groups regarding the Virtual action planning supermarket (VAP-S). The Symbol Digit Modalities Test evaluated the information processing speed, with an oral score revealed pathological in 72.3% of the cohort, which is near ¾ of the patients. This study demonstrates the importance of cognitive impairments in minor stroke patients, as well as their impact on everyday life in terms of life quality and return to work. This shows the interest in implementing systematic post-stroke consultations in minor stroke patients.