Spontaneous Recovery of Executive Function, Attention, and Processing Speed in Stroke Patients in Colombia

Abstract

Background Previous literature has shown disparities between developing and developed regions in executive functioning, attention, and processing speed performance following stroke. Research on post‐stroke longitudinal outcomes in Latin America specifically is almost nonexistent. Objectives To assess spontaneous recovery among individuals with stroke in the absence of cognitive rehabilitation services in Colombia, South America during the first year post‐stroke by comparing their functioning to that of healthy controls across executive functioning, attention, and processing speed at 3, 6, and 12 months. Design Cohort. Setting Stroke rehabilitation center at the regional hospital. Participants A sample of 50 individuals with stroke and 50 matched healthy controls from Colombia were included in this study. Consistent with the healthcare resources in this region, participants did not receive any inpatient or outpatient cognitive rehabilitation. Interventions Not applicable. Main Outcome Measures Executive functioning, attention, and processing speed. Results Hierarchical linear models suggested improvements over time for both individuals with stroke and controls, but trajectories of neuropsychological performance were significantly lower for individuals with stroke. Only on one of nine outcomes was there a significant time*group interaction, suggesting greater gains for the stroke group than controls. Conclusions These data suggest extremely minor spontaneous recovery among individuals with stroke in Colombia relative to practice effects in controls, and that apparent improvements in executive functioning after stroke were likely just due to practice effects. These findings underscore the bleak outcomes in cognitive functioning after stroke that occur in regions without cognitive rehabilitation.

Executive Function Poststroke: Concepts, Recovery, and Interventions

“…75 However, Pugh and coauthors found minimal evidence of recovery of executive function above that observed or expected from practice effects from repeated measures using similar cognitive instruments. 76 Additional studies have sought to quantify the proportions of people who improve or decline in executive function over time. Estimates suggest that 15% to 50% of participants who have executive function impairments within the first 3 months poststroke demonstrate significantly improved test scores over the following 12 months.…”

“…75 However, Pugh and coauthors found minimal evidence of recovery of executive function above that observed or expected from practice effects from repeated measures using similar cognitive instruments. 76…”

Correlação entre funções executivas e independência funcional em indivíduos após acidente vascular encefálico

“…A incapacidade gerada pelo AVE pode impedir a realização de simples tarefas cotidianas reforçando ainda mais o declínio executivo, que é comumente visto nos sobreviventes (PUGH et al 2020). O déficit cognitivo pode permanecer além do estágio agudo da recuperação, prejuízos na memória mostraram estar presentes 11-31% após um ano do acidente vascular cerebral.…”