Chronic Stroke / Dementia

Life after stroke: long term psychological consequences

The project is a Stroke Association Priority Programme Award, following on from our early post-stroke screening programme, where patients are screened for cognitive problems in the acute stroke unit, and subsequently followed up 6 months later at home.

The aim of this project is to determine the prevalence, nature, trajectories and wider impact of cognitive impairment in long term stroke survivors, in relation with mood and fatigue.

A 3 year longitudinal observational study with yearly detailed neuropsychological profiling will be conducted in a well-defined cohort (N=200) of long term (> 2 year) stroke survivors. Importantly, detailed baseline and 6month stroke and cognitive information is available on this cohort. These repeated in depth neuropsychological profiles allow us to distinguish between domain-general (e.g. sustaining attention) and domain-specific cognitive problems (e.g. aphasia), which contribute differentially to recovery and decline. In addition, we will examine the cognitive underpinnings of post stroke fatigue, and map long term changes in mood and behaviour. We will investigate the impact of these complex psychological consequences on survivors’ and their carers, in terms of symptoms, quality of life and achievement of personal goals. This research will significantly enhance our understanding of post-stroke cognition and its inter-relations with mood and fatigue in long term stroke survivors, impacting the policies on planning of services for longer term follow up after stroke. Additionally, specific cognitive intervention developments (e.g. neglect, apraxia) can build on this increased understanding of trajectories.