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01-11-2020 | Stroke | Original Communication

Early cognitive and emotional outcome after stroke is independent of discharge destination

Authors: Jos P. L. Slenders, Daan P. J. Verberne, Johanna M. A. Visser-Meily, Renske M. Van den Berg-Vos, Vincent I. H. Kwa, Caroline M. van Heugten

Published in: Journal of Neurology | Issue 11/2020

Abstract

Background and purpose

Cognitive and emotional problems occur frequently after stroke. Patients with minor stroke are more likely to be discharged home. This paper compares early cognitive and emotional outcomes in patients discharged home after stroke versus patients discharged to inpatient rehabilitation, and examines the effect of cognitive and emotional outcomes on long-term participation.

Methods

In this multicenter prospective cohort study, patients with stroke were assessed at two months with the Hospital Anxiety and Depression Scale (HADS), the Checklist for Cognitive and Emotional Consequences following Stroke (CLCE-24) and the Montreal Cognitive Assessment (MoCA). One year post stroke, participation was assessed with the Restriction subscale of the Utrecht Scale for Evaluation of Rehabilitation—Participation (USER-P Restriction).

Results

The study included 332 patients. Two months post stroke, anxiety and cognitive problems were equally prevalent among patients discharged home (n = 243; 73%) and patients discharged to inpatient rehabilitation (n = 89; 27%) (HADS-A = 4.8 ± 3.9 versus 4.6 ± 4.0, p = 0.747; MoCA < 26: 66.7% versus 70.8%, p = 0.477; CLCE-cognition = 3.0 ± 2.9 versus 3.3 ± 2.8, p = 0.499). Depressive symptoms were less severe in patients discharged home (HADS-D = 4.3 ± 3.9 versus 5.5 ± 3.8, p = 0.010). In patients discharged home, cognitive complaints were predictive of long-term participation (B = − 2.03; 95% CI − 3.15, − 0.90), while cognitive or emotional outcomes were not predictive in patients discharged to inpatient rehabilitation.

Conclusions

Cognitive and emotional problems at two months post stroke were comparable between patients discharged home and those discharged to inpatient rehabilitation. For patients discharged home, cognitive complaints were predictive of long-term participation.

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Title: Early cognitive and emotional outcome after stroke is independent of discharge destination
Authors: Jos P. L. Slenders
Daan P. J. Verberne
Johanna M. A. Visser-Meily
Renske M. Van den Berg-Vos
Vincent I. H. Kwa
Caroline M. van Heugten
Publication date: 01-11-2020
Publisher: Springer Berlin Heidelberg
Keywords: Stroke
Affective Disorder
Affective Disorder
Anxiety
Published in: Journal of Neurology / Issue 11/2020
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-020-09999-7

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Early cognitive and emotional outcome after stroke is independent of discharge destination

Abstract

Background and purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background and purpose

Methods

Results

Conclusions

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