ABSTRACT

A variety of approaches are currently used to explore the relationship between cognitive functioning and participation after stroke. We aimed to gain insight into the preferred approach to measure cognitive functioning when exploring the association between cognitive functioning and participation in the long term after stroke. In this inception cohort study 128 individuals with stroke participated and were assessed at a single time point three to four years after the event. Participation was measured using the Restrictions subscale of the Utrecht Scale for Evaluation of Rehabilitation-Participation. Subjective cognitive complaints were assessed using the Cognition subscale of the Checklist for Cognitive and Emotional Consequences (CLCE-24-C). Objective cognitive performance was measured using the Montreal Cognitive Assessment (MoCA) and a neuropsychological test battery (NTB) testing multiple cognitive domains. Participation showed a strong correlation (r = 0.51) with the CLCE-24-C and moderate correlations with the domains of visuospatial perception (r = 0.37) and mental speed (r = 0.36). Backward linear regression analyses showed that participation restrictions were best explained by the combination of the CLCE-24-C and a test for visuospatial perception (R²= 0.31). Our findings suggest the use of a combination of subjective cognitive complaints and objective cognitive performance to explore the relationship between cognitive functioning and participation after stroke.

摘要

当前使用多种方法来探索中风后认知功能和参与之间的关系。我们的目的是在探索中风后长期的认知功能与参与之间的关联时，了解测量认知功能的首选方法。在这项队列研究中，有128名中风患者参加了该研究，并在事件发生后三到四年的单个时间点进行了评估。使用用于评估康复参与度的乌得勒支量表的“限制”子量表来测量参与度。使用认知和情感后果清单的认知子量表（CLCE-24-C）评估主观认知投诉。使用蒙特利尔认知评估（MoCA）和测试多个认知域的神经心理学测试电池（NTB）来测量客观认知表现。参与表现出很强的相关性（ 与CLCE-24-C的r = 0.51）以及与视觉空间知觉（r  = 0.37）和精神速度（r  = 0.36）的域具有适度的相关性。向后线性回归分析表明，通过将CLCE-24-C和视觉空间知觉测试结合起来，可以最好地解释参与限制（R ² = 0.31）。我们的研究结果表明，结合使用主观认知和客观认知表现来探索中风后认知功能与参与之间的关系。