Participation after a stroke: Changes over time as a function of cognitive deficits

Participation refers to the engagement of a person in daily activities and social roles. The goal of this study was to compare changes in older adults’ participation over time following a stroke as a function of the presence of deficits in memory, visual perception, executive functions, visual attention or language. A total of 197 persons with stroke were assessed 3 weeks, 3 months and 6 months after discharge from an acute care hospital, rehabilitation unit or geriatric day hospital. The Assessment of Life Habits (ALH) was used to measure participation. Neuropsychological measures were used to assess the presence of a cognitive deficit in the domains of memory, visual perception, executive functions (inhibition), visual attention and language. Overall, results indicate that participation after a stroke improves over time after hospital discharge in spite of cognitive deficits. Changes in participation over time differed between unimpaired and impaired participants only for language and executive deficits in three domains: interpersonal relationships, community life and responsibilities. These results indicate that when returning to the community after a stroke, positive changes in participation over time are possible even with cognitive deficits.