Academic Journal
Longitudinal Trajectories of Global and Domain-Specific Cognition After Stroke Using the Oxford Cognitive Screen.
| Τίτλος: | Longitudinal Trajectories of Global and Domain-Specific Cognition After Stroke Using the Oxford Cognitive Screen. |
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| Συγγραφείς: | Milosevich E; Investigative Medicine Division, Radcliffe Department of Medicine (E.M.), University of Oxford, United Kingdom., Kusec A; Nuffield Department of Clinical Neurosciences (A.K., N.D.), University of Oxford, United Kingdom., Pendlebury ST; Nuffield Department of Clinical Neurosciences, Wolfson Centre for Prevention of Stroke and Dementia (S.T.P.), University of Oxford, United Kingdom.; NIHR Oxford Biomedical Research Centre and Departments of General Medicine and Geratology, John Radcliffe Hospital, Oxford, United Kingdom (S.T.P.)., Demeyere N; Nuffield Department of Clinical Neurosciences (A.K., N.D.), University of Oxford, United Kingdom. |
| Πηγή: | Stroke [Stroke] 2026 Jul; Vol. 57 (7), pp. 2150-2162. Date of Electronic Publication: 2026 May 19. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 0235266 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1524-4628 (Electronic) Linking ISSN: 00392499 NLM ISO Abbreviation: Stroke Subsets: MEDLINE |
| Imprint Name(s): | Publication: 1998- : Baltimore, Md. : Lippincott Williams & Wilkins Original Publication: Dallas : American Heart Association |
| Ιατρικοί όροι (MeSH): | Stroke*/complications , Stroke*/psychology , Cognition*/physiology , Cognitive Dysfunction*/etiology , Cognitive Dysfunction*/diagnosis , Cognitive Dysfunction*/psychology, Humans ; Female ; Aged ; Male ; Longitudinal Studies ; Middle Aged ; Neuropsychological Tests ; Executive Function |
| Περίληψη: | Background: Cognitive impairment is common after stroke and linked to poor outcomes, yet long-term recovery or decline, particularly across specific cognitive domains, remains unclear. Most studies use brief global screeners with short follow-up, limiting insight into recovery patterns. This study aimed to characterize domain-specific cognitive trajectories over ≥2 years poststroke and identify predictors of persistent impairment. Methods: Participants were recruited at a regional acute stroke unit (John Radcliffe Hospital, Oxford, United Kingdom; 2012-2019) and assessed acutely, at 6 months, and ≥2 years poststroke. The Oxford Cognitive Screen was administered at all timepoints. Global impairment severity was quantified by the proportion of Oxford Cognitive Screen subtasks impaired. Logistic mixed-effects models examined longitudinal change and predictors of domain-specific impairments (language, memory, attention, executive function, and number processing). Latent class growth analysis identified distinct cognitive trajectories. Models were adjusted for acute cognitive impairment severity and time. Results: Of 866 patients assessed acutely, 105 were followed up at ≥2 years (98 with complete Oxford Cognitive Screen data; median, 4.1 [interquartile range, 3.3] years; mean age, 69 years, 41% female). Cognitive impairment severity improved substantially by 6 months (β=-0.11; P<0.001) and further long-term (β=-0.15; P<0.001). Acute impairment severity strongly predicted long-term outcomes (β=0.50; P<0.001), while demographic and vascular factors explained minimal variance. Latent class growth analysis identified 4 overall trajectories: no or mild acute impairment with stability (47.6%), moderate-improving (32.3%), large improvement (15.2%), and decline (4.8%). Domain-specific improvements were greatest in memory (odds ratio, 16.40 [95% CI, 5.52-48.7]) and language (odds ratio, 8.17 [95% CI, 3.17-21.1]), more limited in attention (odds ratio, 5.41 [95% CI, 2.52-11.6]) and executive function (odds ratio, 4.14 [95% CI, 1.96-8.75]). Domain models revealed additional classes of persistent or delayed recovery, particularly in executive function and attention. Conclusions: Cognitive recovery is most pronounced within 6 months and continues across domains though executive dysfunction often persists. Acute impairment severity best predicted long-term outcomes, while vascular and demographic factors were less informative. Distinct trajectory classes highlight the need for individualized, long-term cognitive monitoring to guide rehabilitation and prognostication. These findings underscore the importance of long-term cognitive follow-up in stroke care and provide empirical benchmarks for recovery across domains. |
| Competing Interests: | E. Milosevich reports grants from Alzheimer’s Research UK. Dr Kusec reports grants from the National Institute for Health and Care Research (NIHR). Dr Demeyere is a developer of the Oxford Cognitive Screen, reports grants from the NIHR, reports additional employment by Elsevier Publishing and the University of Edinburgh, and received consultancy payments from Brain Stimulation (SE). S.T. Pendlebury received honoraria from Trondheim, Sydney, and LaTrobe Universities and royalties from Oxford University Press and Cambridge University Press. |
| Σχόλια: | Comment in: Stroke. 2026 Jul;57(7):2163-2164. doi: 10.1161/STROKEAHA.126.056490.. (PMID: 42330134) |
| Contributed Indexing: | Keywords: cognition; cognitive dysfunction; follow-up studies; long-term care; stroke |
| Entry Date(s): | Date Created: 20260519 Date Completed: 20260622 Latest Revision: 20260726 |
| Update Code: | 20260726 |
| PubMed Central ID: | PMC13281978 |
| DOI: | 10.1161/STROKEAHA.125.054555 |
| PMID: | 42153299 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1524-4628 |
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| DOI: | 10.1161/STROKEAHA.125.054555 |