INS NYC 2024 Program

Poster	Poster Session 03 Program Schedule 02/15/2024 09:30 am - 10:40 am Room: Majestic Complex (Posters 61-120) Poster Session 03: Neurotrauma \| Neurovascular Final Abstract #62 Early Post-stroke Assessment of General Cognitive Ability (g) Predicts 1-year Functional Outcome Alan Romanowski, University of Iowa, Iowa City, United States Mark Bowren, University of Iowa, Iowa City, United States Daniel Tranel, University of Iowa, Iowa City, United States Aaron Boes, University of Iowa, Iowa City, United States Category: Stroke/Cerebrovascular Injury and Disease (Adult) Keyword 1: adaptive functioning Keyword 2: stroke recovery Keyword 3: activities of daily living Objective: Stroke is a leading cause of disability with a high risk for long-term functional impairment. Functional prognosis varies based on individual factors, including post-stroke cognition. In this study we evaluate which assessments of cognitive performance best predict long-term outcomes in stroke. We hypothesize that a composite measure, general cognitive ability (g), estimated from performance on several neuropsychological tests, would provide the best overall predictor of long-term functional independence at 1 year. G is a strong predictor of life outcomes among neurologically healthy individuals, but it has not been evaluated yet as a predictor of post-stroke functional outcomes. We hypothesized g would explain more variance in outcome than individual tests of cognitive performance. Participants and Methods: This study was based on cognitive, functional, and neuroimaging data collected from 69 stroke patients from Washington University in St. Louis. We used exploratory factor analysis (EFA) to derive functional outcome factors based on 5 different measures of functional status collected at 12-months post-stroke. We also used EFA to derive g based on cognitive test data collected within 2 weeks of the stroke onset. We used bivariate correlations and hierarchical linear regressions controlling for age and education to associate g with the functional factors. We also evaluated whether lesion volume and lesion location added predictive value. Results: EFA of functional outcome measures revealed two factors relating to physical and psychosocial functioning. The correlation between acute g and 12-month psychosocial function was statistically significant (r = 0.35, p = 0.003). This was a higher correlation than was observed with any individual cognitive assessment (mean r = 0.045, range 0.014 – 0.235) . In regression models, acute g explained more variance than demographic variables alone (R² = 0.1179 vs 0.02916). Lesion volume and lesion location data did not add additional predictive value beyond g and demographics. In contrast, g was not as highly correlated with the physical functioning outcomes. The strongest correlate of 12 month physical functioning was performance on the star cancellation test (r = -0.32, p = 0.013). Conclusions: Estimation of g from cognitive testing performed in the first weeks after stroke may serve as a more robust predictor of post-stroke psychosocial function relative to other measures, like the NIH stroke scale or individual cognitive tests.

Poster

02/15/2024
09:30 am - 10:40 am
Room: Majestic Complex (Posters 61-120)

Poster Session 03: Neurotrauma | Neurovascular

Final Abstract #62

Early Post-stroke Assessment of General Cognitive Ability (g) Predicts 1-year Functional Outcome

Alan Romanowski, University of Iowa, Iowa City, United States
Mark Bowren, University of Iowa, Iowa City, United States
Daniel Tranel, University of Iowa, Iowa City, United States
Aaron Boes, University of Iowa, Iowa City, United States

Category: Stroke/Cerebrovascular Injury and Disease (Adult)

Keyword 1: adaptive functioning
Keyword 2: stroke recovery
Keyword 3: activities of daily living

Objective:

Stroke is a leading cause of disability with a high risk for long-term functional impairment. Functional prognosis varies based on individual factors, including post-stroke cognition. In this study we evaluate which assessments of cognitive performance best predict long-term outcomes in stroke. We hypothesize that a composite measure, general cognitive ability (g), estimated from performance on several neuropsychological tests, would provide the best overall predictor of long-term functional independence at 1 year. G is a strong predictor of life outcomes among neurologically healthy individuals, but it has not been evaluated yet as a predictor of post-stroke functional outcomes. We hypothesized g would explain more variance in outcome than individual tests of cognitive performance.

Participants and Methods:

This study was based on cognitive, functional, and neuroimaging data collected from 69 stroke patients from Washington University in St. Louis. We used exploratory factor analysis (EFA) to derive functional outcome factors based on 5 different measures of functional status collected at 12-months post-stroke. We also used EFA to derive g based on cognitive test data collected within 2 weeks of the stroke onset. We used bivariate correlations and hierarchical linear regressions controlling for age and education to associate g with the functional factors. We also evaluated whether lesion volume and lesion location added predictive value.

Results:

EFA of functional outcome measures revealed two factors relating to physical and psychosocial functioning. The correlation between acute g and 12-month psychosocial function was statistically significant (r = 0.35, p = 0.003). This was a higher correlation than was observed with any individual cognitive assessment (mean r = 0.045, range 0.014 – 0.235) . In regression models, acute g explained more variance than demographic variables alone (R² = 0.1179 vs 0.02916). Lesion volume and lesion location data did not add additional predictive value beyond g and demographics. In contrast, g was not as highly correlated with the physical functioning outcomes. The strongest correlate of 12 month physical functioning was performance on the star cancellation test (r = -0.32, p = 0.013).

Conclusions:

Estimation of g from cognitive testing performed in the first weeks after stroke may serve as a more robust predictor of post-stroke psychosocial function relative to other measures, like the NIH stroke scale or individual cognitive tests.