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Anxiety and working memory after stroke: implications for norm-referenced methods of identifying cognitive deficits
  1. David C Gillespie
  1. Correspondence to Dr David C Gillespie, Clinical Neuropsychology Service, Department of Clinical Neurosciences (NHS Lothian), Western General Hospital, Edinburgh, EH4 2XU, UK; david.gillespie{at}nhslothian.scot.nhs.uk

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It is well established that stroke can result in impairments of cognitive functioning, particularly early after stroke onset.1 These cognitive impairments have a negative impact on activities of daily living,2 and are associated with lower mood and poorer quality of life.3 Improvement of cognitive functioning is therefore an important goal of rehabilitation.

In clinical settings, the presence of cognitive impairment is usually determined by means of standardised psychometric assessment. A patient's cognitive test performance is compared to the performance of a non-stroke control group on the same test(s). The most appropriate control group is one that is as similar as possible to the patient on factors that are likely to be related to cognitive abilities such as age, gender and educational attainment.

The possible impact of emotional functioning on cognitive performance tends to be given less importance than the demographic factors just mentioned. For example, no adjustment for differences in mood between patients and controls is …

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