This longitudinal study was approved by the Regional Ethical Review Board in Gothenburg (registration number: 426-05 and 042-11) and was conducted in agreement with the Declaration of Helsinki. Researchers can request access to the data by emailing the principal investigator at Study sample and design The complete dataset cannot be made publicly available for ethical and legal reasons, according to Swedish regulations ( ). The study aimed to identify trajectories of cognition during the first year after stroke, and to examine the impact of different trajectory groups in relation to memory performance and activities of daily living. This knowledge will assist in constructing an early individual rehabilitation plan. Exploring these longitudinal trajectories is, therefore, warranted to enhance understanding of the recovery of cognitive function post-stroke while deciphering the heterogeneity 14. Moreover, it is also unknown if patients with varying baseline degrees of cognition will share similar trajectories over time. But if so, it is also not clear when this cognitive decline will occur. It may be that individuals with baseline severe cognitive deficits are more likely to suffer a cognitive decline. To date, it remains unclear how the longitudinal progress of post-stroke cognition varies in patients with different degrees of cognitive functioning in the acute phase. However, the risk of post-stroke dementia may likely be related to the incidence of stroke rather than to the background vascular risk factors 1.
sex, ApoE ε4 status, vascular risk factors) 6, 13. Mixed findings were reported for other risk factors (e.g. Higher age and post-stroke depression in individuals were associated with a cognitive decline 11, 12. A significant decline in global cognition was demonstrated a few years after stroke (from 3 to 6 years) 7, 8, whereas significant improvements in cognition were found within 6-months post-stroke 9, 10. Multiple evolving trends, such as improvement, worsening, or remaining stable, are shown to depend on the use of cognitive instruments, as well as the length of time until follow-up, whether short-term or long-term 6. Longitudinal changes in cognitive function after stroke were largely diverse. The ability to early recognize individuals with potential cognitive decline after stroke would make it possible to appropriately assess their actual needs and additional supports, while tailoring interventions towards these individuals, thus improving their quality of life. In addition to motor impairments, cognition decline is one of the key determinants of deterioration in performance of daily activities after stroke 5. These findings may help to increase focus on long-term rehabilitation plans for those patients, and more accurately assess their needs and difficulties experienced in daily living.Ĭognitive impairment is a highly prevalent long-term stroke consequence, with approximately 80% of patients reporting mild cognitive impairments post-stroke 1, 2, 3, 4. Patients with the poorest cognitive function did not improve at one-year poststroke and were prone to severe memory problems. The impact on memory differs between cognitive functioning groups, whereas the impact on activities of daily living was not different. After age, sex and education matching to the normative MoCA from the Swedish population, 52 patients (55%) were found to be cognitively impaired at baseline, and few patients had recovered at 12 months. For the high and medium groups, cognitive function improved at 12 months, but this did not occur in the low group. Three cognitive functioning groups were identified by the trajectory models: high, medium and low. Data from 94 patients were included in the analysis.
Individuals who shared similar trajectories were classified by applying the group-based trajectory models. The Montreal Cognitive Assessment (MoCA) was used to screen cognitive function at 36–48 h, 3-months, and 12-months post-stroke. The study aimed to determine longitudinal trajectories of cognitive function during the first year after stroke.