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May 15, 2019

ESOC-2019

COGNITIVE PREDICTORS OF MEMORY IMPAIRMENT AFTER STROKE

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Abstract

Background and Aims: Memory impairments are common after stroke and can have significant functional and prognostic implications, but the underlying mechanisms are not well understood. We hypothesized that recall and recognition memory after stroke will be differentially influenced by impairments in other cognitive domains, including executive functions and processing speed. Methods: We retrospectively analysed the performance of 198 stroke patients on the 5-word memory subtest of the MoCA (MoCA-Mem). Patients recalled the words without prompts (‘free-recall’) and then with multiple-choice (‘recognition’). Using multiple linear regression, we investigated the association between MoCA-Mem performance and performance on 1) the other MoCA subtests, and 2) neuropsychology assessment of executive functions, processing speed and language. We also examined the positive and negative predictive value (PPV and NPV) of the MoCA-Mem for predicting impairment based on neuropsychology assessment of memory. Results: Of the 198 patients, 89% failed on the MoCA-Mem free-recall while 30% failed on recognition. Of the other MoCA subtests, performance on the executive domain was the only significant predictor of free-recall, while none were predictive of recognition. On neuropsychology assessment, executive function and processing speed was predictive of free-recall while language impairment was predictive of recognition. Using performance on neuropsychology assessment as the criteria, MoCA-Mem free-recall had good NPV (90.91%) but very poor PPV (42.68%) while recognition had both moderate NPV (70.83%) and PPV (71.43%). Conclusions: Recall and recognition memory impairment after stroke likely arise from separable cognitive processes. Our findings suggest that recognition memory tests may be more useful when assessing memory impairment after stroke.

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© Copyright 2019 Morressier GmbH.
All rights reserved.