Intraindividual variability in post-stroke cognition and its relationship with activities of daily living and social functioning: an ecological momentary assessment approach.
| Autor: | Munsell EGS; Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA.; Center for Education in Health Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA., Bui Q; Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA., Kaufman KJ; Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA., Tomazin SE; Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA., Regan BA; Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA., Lenze EJ; Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA., Lee JM; Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA., Mohr DC; Center for Behavioral Intervention Technologies and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA., Fong MWM; Michigan Avenue Neuropsychologists, Chicago, IL, USA., Metts CL; Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, USA., Pham V; Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA., Wong AWK; Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA.; Department of Physical Medicine and Rehabilitation and Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | Topics in stroke rehabilitation [Top Stroke Rehabil] 2024 Sep; Vol. 31 (6), pp. 564-575. Date of Electronic Publication: 2024 Jan 26. |
| DOI: | 10.1080/10749357.2024.2307203 |
| Abstrakt: | Introduction: Ecological momentary assessment (EMA) is a methodological approach to studying intraindividual variation over time. This study aimed to use EMA to determine the variability of cognition in individuals with chronic stroke, identify the latent classes of cognitive variability, and examine any differences in daily activities, social functioning, and neuropsychological performance between these latent classes. Methods: Participants ( N = 202) with mild-to-moderate stroke and over 3-month post-stroke completed a study protocol, including smartphone-based EMA and two lab visits. Participants responded to five EMA surveys daily for 14 days to assess cognition. They completed patient-reported measures and neuropsychological assessments during lab visits. Using latent class analysis, we derived four indicators to quantify cognitive variability and identified latent classes among participants. We used ANOVA and Chi-square to test differences between these latent classes in daily activities, social functioning, and neuropsychological performance. Results: The latent class analysis converged on a three-class model. The moderate and high variability classes demonstrated significantly greater problems in daily activities and social functioning than the low class. They had significantly higher proportions of participants with problems in daily activities and social functioning than the low class. Neuropsychological performance was not statistically different between the three classes, although a trend approaching statistically significant difference was observed in working memory and executive function domains. Discussion: EMA could capture intraindividual cognitive variability in stroke survivors. It offers a new approach to understanding the impact and mechanism of post-stroke cognitive problems in daily life and identifying individuals benefiting from self-regulation interventions. |
| Databáze: | MEDLINE |
| Externí odkaz: |
|