Associations between non-verbal cognitive assessment and stroke recovery via screening test for aphasia and dysarthria

J Stroke Cerebrovasc Dis. 2024 Dec 28;34(2):108217. doi: 10.1016/j.jstrokecerebrovasdis.2024.108217. Online ahead of print.

Abstract

Objective: Non-verbal Screening Test for Aphasia and Dysarthria scores correlate with post-stroke cognitive function; however, their correlations with activities of daily living dependency and home discharge (cognitive function-associated outcomes) remain unclear. We investigated the correlation of these scores with activities of daily living dependency and home discharge outcomes.

Materials and methods: Disability levels and functional outcomes of 278 inpatients with brain injury (age: 72.8 ± 13.0 years) were evaluated using the modified Rankin Scale. Patients were grouped according to activities of daily living dependency (independent [n = 96; modified Rankin Scale score≤2]) and non-home discharge (n = 126) status. Factors predicting home discharge were analyzed using univariate and multivariate logistic regression analyses.

Results: Cognitive impairment was more prevalent in the activities of daily living-dependent group than in the independent group (odds ratio: 6.34 [95 % confidence interval: 3.57-11.52]; p < 0.001) and in the non-home discharge than in the home discharge group (2.78 [1.65-4.73]; p < 0.001). Non-verbal test scores correlated moderately with activities of daily living independence and home discharge. Age, modified Rankin Scale score, cognitive impairment, and the Screening Test for Aphasia and Dysarthria scores were significantly associated with home discharge in univariate analyses. Only modified Rankin Scale and non-verbal test scores were significantly associated with home discharge in multivariate analysis (p < 0.001).

Conclusions: Non-verbal test scores were significantly associated with activities of daily living independence and home discharge in patients with stroke. The non-verbal test, being less influenced by communicative disorders, offers a novel tool for estimating cognitive function.

Keywords: Activities of daily living; Brain injuries; Cognitive dysfunction; Logistic models; Non-verbal cognitive tests; Odds ratio; Patient discharge; Predictive value of tests.