Around two thirds of people in the acute phase of stroke recovery will experience dysphagia. Up to six months following a stroke this may be present in 13-18% of cases. The degree of cognitive impairment seems to be associated with the presence of dysphagia with incoordination of the lip, the tongue, and oropharynx being commonly associated with cognitive difficulties. This study aimed to explore the association between cognitive impairment and the recovery of dysphagia symptoms on discharge from inpatient rehabilitation. The data analysed in this study come from a multicentre prospective study across four intensive rehabilitation units. Fifty-five patients met the inclusion criteria for the study (first-ever or recurrent ischemic or haemorrhagic stroke, had dysphagia, and had completed a dysphagia rehabilitation training at discharge). The Functional Oral Intake Scale, a validated graded scale with seven levels, was administered by the speech and language therapist within two working days from admission, and again at discharge. The Montreal Cognitive Screening Test is a cognitive screening composed of brief cognitive tasks that assess different cognitive areas and was also administered by the speech and language therapist on admission. Results show that lower cognitive scores, specifically lower executive function sub scores, were significantly and positively associated with lower dysphagia outcomes at discharge, yet stroke severity was not. These are important markers for prognosis and should inform management plans for rehabilitation services.
Foretelling: post-stroke recovery of dysphagia is predicted by cognition
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