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Abstract

Objective: Few studies have examined the relationship between cognition and function in stroke inpatients utilizing comprehensive methods. This study aimed to assess the relationship of a neuropsychological model, above and beyond a medical model, with concurrent functional status across multiple domains in the early stages of stroke recovery. Methods: Seventy-five acute stroke patients were administered a comprehensive neuropsychological assessment. Functional domains of ability, adjustment, and participation were assessed using the Mayo-Portland Adaptability Inventory - 4 (MPAI-4). Hierarchical linear regression was used to first account for a medical model comprised of neuroimaging results, co-morbid factors, and demographic information, followed by a neuropsychological model comprised of composite scores derived from neuropsychological tests of executive function, memory, visuospatial-constructional skills (VSC), and language. Results were examined for the sample as a whole, and after segregating the sample by stroke location using the Oxfordshire Community Stroke Project (OCSP) Classification System. Results: The neuropsychological model was significantly associated, above and beyond the medical model, with MPAI-4 Ability, Participation, and Total scores (all p-values < .05). The strength of association varied across functional domains, and was dependent on stroke location. Specifically, in anterior region strokes, executive function was significantly associated with MPAI-4 Total and Ability subscales (all p-values < .05). In posterior region strokes, VSC was significantly associated with MPAI-4 Adjustment, and memory was significantly associated with MPAI-4 Total (all p-values