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Research Article
Nagaendran Kandiah
National Neuroscience Institute
Corresponding Author
License:
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Background
Persons with mild stroke experience minimal functional difficulties; nonetheless, they are at elevated risk for post-stroke cognitive impairment (PSCI) and cognitive decline.
Aims
We report outcomes from an observational cohort study of a structured, multidomain intervention for persons with mild strokes.
Methods
The Stroke Memory RehabiliTation (SMaRT) program comprises weekly two-hour group sessions for six weeks on cognitive strategies, lifestyle and relaxation. Participants were recruited from a tertiary hospital between June 2018 to September 2019. They had MRI-confirmed ischemic strokes with mild functional difficulties (modified Rankin Scale score ≤3). Participants underwent assessments and questionnaires at baseline, 1-week post-program, 3 months post-program, and 6 months post-program.
Results
Participants (N=108, mean age=63.54±9.22, 31.5% female) demonstrated significant improvement in cognition, mood, activities of daily living (ADL) and quality of life (QOL) (ps<0.05) across timepoints. Participants performed significantly better at 6 months post-program compared to baseline on cognitive tests (MoCA 24.47±3.22 vs. 25.80±2.83, Beta=1.26, 95% CI(0.78,1.74)), p<.001; Visual Cognitive Assessment Test (22.74±3.98 vs. 24.76±3.68, Beta=2.04, 95% CI(1.44,2.65), p<.001); 87% of participants maintained or improved in performance. At 6 months post-program, participants reported greater functional independence (Nottingham Extended ADLs Questionnaire Beta=4.20, 95% CI(2.63,5.77), p<.001); fewer depressive symptoms (Geriatric Depression Scale Beta=-1.44, 95% CI(-1.94, -0.94), p<.001); and improved QOL (Dementia-QOL Questionnaire Beta=5.28, 95% CI(1.09, 2.57), p<.001).
Conclusions
The SMaRT program is a cost-effective, scalable, structured program for PSCI. Findings suggest its potential effectiveness in reducing cognitive decline and improving other domains of well-being, with carry-over benefits after 6 months.
Keywords
Rehabilitation, Cognitive Impairment, Stroke, Stroke Rehabilitation, Cognitive Rehabilitation, Multidisciplinary Rehabilitation
Figure 1
No competing interests reported.
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Reviewer #1 agreed
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Reviewer #4 agreed
On 11 Apr, 2021
Reviewer #2 agreed
On 11 Apr, 2021
Reviewers invited
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Subject Areas
Neurology
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This preprint is under consideration at Scientific Reports. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Nagaendran Kandiah
National Neuroscience Institute
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 05 Mar, 2021
No community comments so far
Reviewer #3 agreed
On 11 Apr, 2021
Reviewer #5 agreed
On 11 Apr, 2021
Reviewer #1 agreed
On 11 Apr, 2021
Reviewer #4 agreed
On 11 Apr, 2021
Reviewer #2 agreed
On 11 Apr, 2021
Reviewers invited
Invitations sent on 31 Mar, 2021
Editor assigned
On 31 Mar, 2021
Editor invited
On 22 Feb, 2021
Submission checks complete
On 22 Feb, 2021
First submitted
On 18 Feb, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Neurology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Persons with mild stroke experience minimal functional difficulties; nonetheless, they are at elevated risk for post-stroke cognitive impairment (PSCI) and cognitive decline.
Aims
We report outcomes from an observational cohort study of a structured, multidomain intervention for persons with mild strokes.
Methods
The Stroke Memory RehabiliTation (SMaRT) program comprises weekly two-hour group sessions for six weeks on cognitive strategies, lifestyle and relaxation. Participants were recruited from a tertiary hospital between June 2018 to September 2019. They had MRI-confirmed ischemic strokes with mild functional difficulties (modified Rankin Scale score ≤3). Participants underwent assessments and questionnaires at baseline, 1-week post-program, 3 months post-program, and 6 months post-program.
Results
Participants (N=108, mean age=63.54±9.22, 31.5% female) demonstrated significant improvement in cognition, mood, activities of daily living (ADL) and quality of life (QOL) (ps<0.05) across timepoints. Participants performed significantly better at 6 months post-program compared to baseline on cognitive tests (MoCA 24.47±3.22 vs. 25.80±2.83, Beta=1.26, 95% CI(0.78,1.74)), p<.001; Visual Cognitive Assessment Test (22.74±3.98 vs. 24.76±3.68, Beta=2.04, 95% CI(1.44,2.65), p<.001); 87% of participants maintained or improved in performance. At 6 months post-program, participants reported greater functional independence (Nottingham Extended ADLs Questionnaire Beta=4.20, 95% CI(2.63,5.77), p<.001); fewer depressive symptoms (Geriatric Depression Scale Beta=-1.44, 95% CI(-1.94, -0.94), p<.001); and improved QOL (Dementia-QOL Questionnaire Beta=5.28, 95% CI(1.09, 2.57), p<.001).
Conclusions
The SMaRT program is a cost-effective, scalable, structured program for PSCI. Findings suggest its potential effectiveness in reducing cognitive decline and improving other domains of well-being, with carry-over benefits after 6 months.
Figure 1
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