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A Positive Relationship between Cognitive Reserve and Cognitive Function after Stroke: Dynamic Proxies Correlate Better than Static Proxies

Published online by Cambridge University Press:  18 July 2019

Macarena Gil-Pagés Open the ORCID record for Macarena Gil-Pagés [Opens in a new window] ,
Rocío Sánchez-Carrión ,
Jose M. Tormos ,
Antonia Enseñat-Cantallops  and
Alberto García-Molina
Macarena Gil-Pagés*
Affiliation:
Institut Guttmann, Institut Universitari de Neurorehabilitació, adscrit a la Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain Fundació Institut d´Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
Rocío Sánchez-Carrión
Affiliation:
Institut Guttmann, Institut Universitari de Neurorehabilitació, adscrit a la Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain Fundació Institut d´Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain
Jose M. Tormos
Affiliation:
Institut Guttmann, Institut Universitari de Neurorehabilitació, adscrit a la Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain Fundació Institut d´Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain
Antonia Enseñat-Cantallops
Affiliation:
Institut Guttmann, Institut Universitari de Neurorehabilitació, adscrit a la Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain Fundació Institut d´Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain
Alberto García-Molina
Affiliation:
Institut Guttmann, Institut Universitari de Neurorehabilitació, adscrit a la Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain Fundació Institut d´Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain
*
*Correspondence and reprint requests to: Mailing address: Cami de Can Ruti s/n, 08916 Badalona, Barcelona, Spain. E-mail: macarenagil@guttmann.com. Telephone number: (+34) 934977700 ext.2141
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Abstract

Objectives: How brain damage after stroke is related to specific clinical manifestation and recovery is incompletely understood. We studied cognitive reserve (CR) in stroke patients by two types of measurements: (i) objectively verifiable static proxies (i.e., education, occupational attainment), and (ii) subjective, dynamic proxies based on patient testimony in response to a questionnaire. We hypothesized that one or both of these types of CR measurements might correlate positively with patient cognitive performance during the post-acute and chronic phases of recovery. Method: Thirty-four stroke patients underwent neuropsychological assessment at 2, 6 and 24 months after stroke onset. In chronic stage at 24+ months, self-rating assessments of cognitive performance in daily life and social integration were obtained. CR before and after stroke was estimated using static proxies and dynamic proxies were obtained using the Cognitive Reserve Scale (CRS-Pre-stroke, CRS-Post-stroke). Results: CRS-Pre-stroke and CRS-Post-stroke showed significant mean differences. Dynamic proxies showed positive correlation with self-assessment of attention, metacognition, and functional ability in chronic stage. In contrast, significant correlations between static proxies and cognitive recovery were not found. Conclusions: Dynamic proxies of CR were positively correlated with patients’ perception of their functional abilities in daily life. To best guide cognitive prognosis and treatment, we propose that dynamic proxies of CR should be included in neuropsychological assessments of patients with brain damage.

Keywords

Brain injuryDaily livingSelf-assessmentPrognosisCognitionNeuropsychological tests

Information

Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 25 , Issue 9 , October 2019 , pp. 910 - 921
Copyright
Copyright © INS. Published by Cambridge University Press, 2019. 

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