Exploring The Effects Of Post-Stroke Cognitive Impairment And Dementia On Patients’ Quality Of Life And Independence

Abstract

Background: Post-stroke cognitive impairment (PSCI) and dementia are common consequences of stroke, significantly affecting patients' quality of life (QoL), independence, and emotional well-being.  Objectives: The primary objective of this study was to evaluate the effects of post-stroke cognitive impairment and dementia on stroke survivors' quality of life and independence.  Methods: A cross-sectional study was conducted involving 85 stroke patients, recruited from two tertiary care hospitals in an urban area selectedfor their high volume of cardiovascular cases and accessiblilty for young patients.  Cognitive functioning was assessed using the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE). Quality of life was measured using the Stroke Specific Quality of Life Scale (SS-QOL) and EuroQol-5D (EQ-5D). Functional independence was evaluated using the Functional Independence Measure (FIM) and the Lawton-Brody Instrumental Activities of Daily Living Scale (IADL). Emotional well-being was assessed using the Hospital Anxiety and Depression Scale (HADS).  Results: The findings indicated that a significant proportion of stroke survivors experienced varying degrees of cognitive impairment, with 40% showing severe cognitive decline. The mean SS-QOL score was 47.8, reflecting a moderate to severe decline in quality of life, particularly in the emotional well-being domain. Most patients required assistance with daily activities, with 75% needing help with physical independence and 65% requiring cognitive assistance. High levels of anxiety and depression were reported by 50% and 45% of participants, respectively. Caregivers reported substantial emotional and physical strain, with a mean caregiver burden score of 52.6. Conclusions: Post-stroke cognitive impairment and dementia significantly affect stroke survivors' quality of life, independence, and emotional health. The findings highlight the need for comprehensive rehabilitation programs that address both cognitive and emotional needs.