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Cognitive complaints in the early phase after stroke are not indicative of cognitive impairment

¹ Department of Psychology, University Hospital Maastricht, Maastricht, The Netherlands
² Department of Neurology, University Hospital Maastricht, Maastricht, The Netherlands
³ European Graduate School of Neuroscience (EURON), Maastricht University, Maastricht, The Netherlands
⁴ Centre of excellence in rehabilitation medicine de Hoogstraat, Utrecht, The Netherlands

Correspondence to:
Dr Annelien Duits, Department of Psychology, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands; adui{at}smps.azm.nl

Objective: The present study was designed to evaluate the diagnostic contribution of subjective information, obtained by a standardised checklist, to the identification of patients with cognitive impairment in the early phase after stroke.

Methods: The data were collected retrospectively by file analysis of both medical and psychological records of patients with a first-ever stroke who were discharged home from the stroke unit. All these patients underwent neuropsychological examination by protocol. Patients were included for data analyses if they completed the Checklist for Cognitive and Emotional consequences following stroke within 2 weeks after discharge. Data from a control group were used to classify patients into normal and cognitively impaired.

Results: A total of 61 patients was included in the study. Ninety percent reported at least one psychological problem hindering daily life and 74% of the total sample reported at least one hindering cognitive problem. The most reported cognitive complaints concerned attention (38%), mental speed (46%) and memory (38%). Cognitive impairment varied between 16 and 66% based on the specific neuropsychological task. Cognitive complaints appeared to be unrelated to cognitive impairment. Only the relationship between cognitive and emotional complaints was significant (p<0.01).

Conclusions: Cognitive complaints hindering daily life are frequently reported in the early weeks after stroke but are no indication for impaired cognitive performance. To identify patients with cognitive impairment, neuropsychological assessment is essential.

Keywords: stroke; cognitive; impairment; anxiety; depression; neuropsychological