Cognitive reserve and functional, psychological and cognitive ability following stroke

Rosenich, E.1, Hordacre, B.1 & Hillier, S. L.1

1 Innovation, Implementation & Clinical Translation in Health (IIMPACT), University of South Australia

 

Background & aims: Cognitive reserve (CR) is a feature of brain structure and function said to mediate the effects of brain pathology or injury on clinical outcomes. Extensively studied in neurodegeneration, CR demonstrates increasing applicability to acute neurological injury, such as stroke, but has not been comprehensively explored. Here we report stroke outcomes at baseline and 3-months for those with low and high CR.

Methods: Thirty-three acute, first-ever stroke patients admitted to a specialised stroke unit at the Royal Adelaide Hospital, were assessed on CR, cognition, function, quality-of-life and self-efficacy at baseline. Participants were dichotomised into high or low CR-groups based on Cognitive Reserve Index questionnaire criteria. Fugl-Meyer Assessment (upper-limb) and Montreal Cognitive Assessment were completed to describe clinical characteristics of high/low CR groups. Outcomes measured disability, independence, self-efficacy, and quality-of-life.

Results: Baseline characteristics were similar between groups, except for cognitive ability, where those with high CR (M= 23.5, SD= 4.8) significantly outperformed those with low CR (M= 19, SD= 1; p= 001). Preliminary 3-month data shows a trend for the low CR group to demonstrate poorer outcomes (M difference from baseline) on measures of independence (M=-21.5), disability (M=+0.17), quality-of-life (M=+14.8), and self-efficacy (M=-19.7).

Conclusions: While current findings are preliminary and should be interpreted with caution, CR may be an important mediator of stroke outcomes. Importantly, CR is modifiable across the lifespan and might demonstrate utility for primary/secondary prevention, health promotion/intervention, prediction of recovery following stroke and clinical decision-making.


Emily Rosenich

Emily holds a Bachelor of Psychology with honours and is a final-year PhD candidate in the Division of Health Sciences at the University of South Australia. Her doctoral research focuses on understanding how cognitive reserve influences cognitive, motor, and psychological impairment and recovery, as well as neurophysiological brain change (functional connectivity), following stroke. Throughout her PhD, Emily has been awarded an emerging early-career researcher in cognitive ageing travel award and has conducted a research internship at the prestigious Institute for Stroke and Dementia at the Ludwig-Maximillian’s University of Munich, Germany. In addition to her scientific work, Emily is a passionate science communicator and advocate for young people and women in science and is frequently involved in community outreach activities aimed at increasing the visibility of women in science.

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