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The role of objective cognitive dysfunction in subjective cognitive complaints after stroke
Author(s) -
Rijsbergen M. W. A.,
Mark R. E.,
Kop W. J.,
Kort P. L. M.,
Sitskoorn M. M.
Publication year - 2017
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13227
Subject(s) - cognition , neuropsychology , stroke (engine) , multivariate statistics , medicine , neuropsychological test , rivermead post concussion symptoms questionnaire , cognitive test , neuropsychological assessment , multivariate analysis , effects of sleep deprivation on cognitive performance , montreal cognitive assessment , clinical psychology , psychology , psychiatry , cognitive impairment , statistics , mechanical engineering , mathematics , engineering
Background and purpose Objective cognitive performance ( OCP ) is often impaired in patients post‐stroke but the consequences of OCP for patient‐reported subjective cognitive complaints ( SCC ) are poorly understood. We performed a detailed analysis on the association between post‐stroke OCP and SCC . Methods Assessments of OCP and SCC were obtained in 208 patients 3 months after stroke. OCP was evaluated using conventional and ecologically valid neuropsychological tests. Levels of SCC were measured using the CheckList for Cognitive and Emotional (CLCE) consequences following stroke inventory. Multivariate hierarchical regression analyses were used to evaluate the association of OCP with CLCE scores adjusting for age, sex and intelligence quotient. Analyses were performed to examine the global extent of OCP dysfunction (based on the total number of impaired neuropsychological tests, i.e. objective cognitive impairment index) and for each OCP test separately using the raw neuropsychological (sub)test scores. Results The objective cognitive impairment index for global OCP was positively correlated with the CLCE score (Spearman's rho = 0.22, P = 0.003), which remained significant in multivariate adjusted models ( β = 0.25, P = 0.01). Results for the separate neuropsychological tests indicated that only one task (the ecologically valid Rivermead Behavioural Memory Test) was independently associated with the CLCE in multivariate adjusted models ( β = −0.34, P < 0.001). Conclusions Objective neuropsychological test performance, as measured by the global dysfunction index or an ecologically valid memory task, was associated with SCC . These data suggest that cumulative deficits in multiple cognitive domains contribute to subjectively experienced poor cognitive abilities in daily life in patients post‐stroke.