Course and Predictors of Subjective Cognitive Complaints During the First 12 Months after Stroke

Abstract

Background: Subjective Cognitive Complaints (SCC) are common after stroke. This study documents the prevalence and course of SCC in the first year after stroke and determines which patient characteristics in the first 3 months predict subsequent SCC at 1-year follow-up.

Methods: Using a longitudinal design, 155 patients (mean age 64.0 ± 11.9 years; 69.7% men) were assessed at 3 and 12 months after stroke. SCC were assessed using the Checklist for Cognitive and Emotional consequences following stroke (CLCE) inventory (content component [CLCE-c] and worry component [CLCE-w]). Potential predictors of 12 months SCC included demographics, stroke severity, objective cognitive impairment, psychological factors (depression, anxiety, perceived stress, fatigue, personality traits, coping style), and activities of daily life functioning assessed at 3 months poststroke. Multiple hierarchical linear regression analyses were used to determine predictors of SCC at 12 months poststroke.

Results: SCC remained stable from 3 to 12 months over time (CLCE-c from 3.3 ± 2.4 to 3.3 ± 2.6; CLCE-w: from 1.9 ± 2.2 to 2.1 2.5). Independent predictors of SCC at 12 months were baseline CLCE-c (β = 0.54) and perceived stress (β = 0.23) for content, and baseline CLCE-w (β = 0.57) and depressive symptoms (β = 0.23) for worry.

Conclusions: Patients who report SCC at 3 months after stroke are likely to continue having these complaints at 1 year follow-up. Perceived stress and depressive symptoms additionally increase the likelihood of having SCC at 12 months, independent of SCC at 3 months poststroke. Rehabilitation programs that target reduction of stress and depression in the first months after stroke might reduce sustained SCC and improve well-being.

Keywords: Depression; longitudinal; stress stroke; subjective cognitive complaints.