How does cognitive ability affect stroke rehabilitation outcomes?

Abstract

Background: This paper discusses literature findings on the impact of pre-stroke degenerative cognitive impairments (pre-stroke dementia) on post-stroke rehabilitation outcomes. This association has practical implications for stroke rehabilitation services which are faced with the dilemma that pre-stroke cognitive impairment may be a cause of stroke and, on the other hand, stroke may cause cognitive deficits. Content: The link between pre-stroke dementia and stroke is described by explaining how vascular and neurodegenerative pathology contribute to stroke occurrence and to stroke related impairment. Stroke seems to be more closely related to dementia than previously thought and vascular factors appear to be at the core of a wide range of dementing disorders. The literature reviewed emphasises how cognitive performance at stroke onset can give indications about the anticipated level of post-stroke functional independence. Conclusion: The importance of assessing and monitoring cognitive performance of stroke survivors using reliable neuropsychological procedures is emphasised. The assessment results help to estimate rehabilitation potential, to plan the most effective interventions and to optimise post-hospital discharge arrangements. This helps clinicians on stroke units to make rehabilitation decisions addressing both cognitive variables and professional standards.