Cognitive Impairments Impact Functional Mobility in Stroke Survivors

Abstract

Background

Functional mobility is essential for maintaining independence and relies on both motor and cognitive processes. Although the impact of motor impairments on functional mobility in stroke survivors has been extensively studied, the influence of post-stroke cognitive impairments has been largely overlooked. The aim of the current study is 2-fold. First, to determine the impact of post-stroke cognitive impairments on functional mobility across a broad spectrum of tasks. Second, to determine if cognitive impairment has a differential impact on various forms of mobility.

Method

Forty individuals with stroke (20 cognitively normal and 20 cognitively impaired) and 30 healthy older adults participated in the study. Participants performed cognitive, motor, and mobility assessments. Cognitive tests included global and domain-specific assessments on an extensive neuropsychological battery. Motor tests included the Modified Rankin Scale and strength assessments. Functional mobility included the assessment of balance, overground walking, and driving in a simulator.

Results

Findings indicated that stroke survivors with cognitive impairment demonstrated significant deteriorations in functional mobility across multiple domains, compared to both cognitively normal stroke survivors and healthy older adults. Cognitive impairment significantly interferes with functional mobility, with driving showing greatest deterioration compared to balance and walking performance. Notably, this impact is independent of the level of disability and motor strength.

Conclusion

Cognitive impairments in stroke survivors are associated with significant mobility disturbances, with the most pronounced deficits in driving performance. This study highlights the importance of including and prioritizing cognitive evaluation and intervention for enhancing functional mobility and independence in stroke survivors.