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Aging Ment Health. 2019 Sep;23(9):1227-1233. doi: 10.1080/13607863.2018.1481927. Epub 2018 Oct 27.

Lived experiences of chronic cognitive and mood symptoms among community-dwelling adults following stroke: a mixed-methods analysis.

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a Division of Rehabilitation Sciences, School of Health Professions , University of Texas Medical Branch at Galveston (UTMB) , Galveston , TX , USA.
b Sealy Center on Aging, UTMB , Galveston , TX , USA.
c Brain Injury Research Center , TIRR Memorial Hermann , Houston , TX , USA.
d Department of Occupational Therapy , School of Health Professions, UTMB , Galveston , TX , USA.
e Division of Clinical Neuropsychology and Psychology , University of Gdansk , Gdansk , Poland.
f Departments of Physical Medicine and Rehabilitation & Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Department of Psychiatry , Baylor College of Medicine , Houston , TX , USA.
g Center for Neurotrauma Rehabilitation , Department of Physical Medicine & Rehabilitation, Harris Health System , Houston , TX , USA.
h Department of Preventive Medicine and Community Health , UTMB , Galveston , TX , USA.
i Department of Family Medicine , UTMB , TX , USA.


Objectives: Few studies have explored the lived experiences of chronic cognitive and mood symptoms following stroke using a racially/ethnically diverse sample. Therefore, we aimed to explore the perceptions of chronic post-stroke cognition and mood symptoms and goals among a racially/ethnically diverse sample of community-dwelling adults aging with stroke. Method: This qualitative study using mixed-methods analysis included semi-structured interviews regarding perceived post-stroke cognitive and mood symptoms among community-dwelling stroke survivors at least one-year post stroke. Transcripts were subjected to thematic content analysis, and differences in theme usage patterns by age, gender, race/ethnicity, and post-acute rehabilitation setting were assessed using an inferential clustering technique. Results: The majority of participants (93%) reported cognition-related themes, including language and communication, memory, thinking abilities, comprehension, visual-spatial processing, and cognitive assessments and training. Nearly half of participants mentioned mood-related themes, including depression, aggression and anger, mood fluctuations, anxiety, and psychological services and medication. Nearly half reported an unmet need for cognition or mood-related treatment. Inferential clustering analysis revealed that older participants reported a different pattern of cognitive and mood symptoms than those aged younger than 65 (p = 0.02). Older adults were more likely to describe post-stroke language/communication changes, while younger adults described post-stroke mood changes. Conclusion: Stroke survivors experienced cognitive and mood-related symptoms beyond one-year post stroke, which has implications for long-term assessment and management. Incorporation of continued symptom monitoring into existing community-based services is needed to address chronic cognitive and mood symptoms affecting the quality of life of persons with stroke.


Cognition; psychological and behavioral symptoms; qualitative methods; quality of life/wellbeing; stroke

[Available on 2020-09-01]

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