Institute of Neuroscience and Physiology/Occupational therapy, Sahlgrenska Academy University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
Acta Neurol Scand. 2010 Dec;122(6):430-7. doi: 10.1111/j.1600-0404.2010.01337.x.
To examine whether there were any differences in the recovery in performance of personal activities of daily living (P-ADL) in elderly persons in relation to cognitive impairments pre- and post-stroke from discharge to 6 and 12 months in elderly persons.
Forty-five elderly persons after stroke were assessed at discharge from hospital and at 6 and at 12 months after stroke onset. A questionnaire posed to the next of kin was used to evaluate the person's pre- and post-stroke cognitive status. P-ADL was assessed with the Barthel Index. The Mini Mental State Examination and neuropsychological tests were used to measure cognitive functions after stroke. The National Institute of Health Stroke Scale was used to measure neurological deficits.
Persons with cognitive impairments before and after stroke did not improve in P-ADL from the acute phase until 6 and 12 months, while persons with intact cognition pre- and post-stroke did.
Since cognitive problems pre- and post-stroke hinder recovery in P-ADL, it is important to understand the connection between cognitive impairment and activity limitations when planning the optimal rehabilitation, which could include special compensation strategies, learnt by the patients, cognitive assistive devices and/or appropriate personal support trained in meaningful activities in daily life in their natural environment.
探讨老年脑卒中患者出院后 6 个月和 12 个月时，个人日常生活活动（P-ADL）表现恢复情况与认知障碍的相关性，分析认知障碍对脑卒中患者 P-ADL 恢复的影响。
选择 45 例老年脑卒中患者，分别在患者出院时、发病后 6 个月和 12 个月进行评估。通过对患者家属进行问卷调查，评估患者发病前后的认知状态。采用 Barthel 指数评估 P-ADL，采用简易精神状态检查量表和神经心理学测验评估认知功能，采用国立卫生研究院卒中量表评估神经功能缺损情况。
脑卒中后认知障碍患者的 P-ADL 在急性期至 6 个月和 12 个月均未得到改善，而认知正常的患者则得到了改善。
认知障碍可影响脑卒中患者 P-ADL 的恢复，因此在制定最佳康复计划时，了解认知障碍与活动受限之间的关系非常重要，康复计划可以包括特殊的补偿策略、认知辅助设备和/或适当的个人支持，以帮助患者在日常生活中进行有意义的活动。
