Cognitive dysfunction, functional independence and depression severity influences rehabilitation for patients after cerebral stroke

Abstract

Introduction Cognitive impairment and depression are frequent residual consequences of stroke. They have a large impact on quality of life and long-term prognosis. Aim The aim is to estimate changes of cognitive dysfunction, functional independence and depression severity before and after rehabilitation in patients after cerebral stroke. Methods We used Mini-Mental State Examination (MMSE) to estimate cognitive dysfunction, Functional Independence Measure (FIM) - motor and cognitive functions, Montgomery-Asberg Depression Rating Scale (MADRS) - depression severity. The permission to use MADRS was granted (©Stuart Montgomery 1978, Measures of Depression, Fulcrum Press, London). Data analysis performed by SPSS Statistics 25.0.0. Results 23 participants from Department of Neurorehabilitation in Hospital of LUHS Kauno klinikos enrolled in the research. 56.5 % were men (n=13). Average age was 65.70 (median 67, standart deviation (SD) 12,68). Youngest patient was 46 years old, oldest - 86. Before rehabilitation the mean score of MMSE – 22.09 – mild cognitive dysfunction, the mean score of FIM – 63.57 – moderate assistance needed, the mean score of MADRS – 15.52 – mild depression. Average days of rehabilitation was 51.87 (median 52, SD 2.83, minimum 43, maximum 54). After rehabilitation the mean score of MMSE – 25.48 – normal cognitive function, the mean score of FIM – 93.7 – supervision needed, the mean score of MADRS – 8.91 – mild depression. We determined that women had worse cognitive dysfunction before rehabilitation than men (p<0,001). Other demographic characteristics didn’t have influence to cognitive function before rehabilitation. Conclusions Speech disorder had statistically significant negative correlation with cognitive function before rehabilitation (r= -0,483, p=0,02). Cognitive function after rehabilitation statistically significant got better(r=0,797, p<0,001). Patients restored normal cognitive function. Functional indep