Cognitive performance and stroke-specific quality of life four years after stroke

Nothing here gets survivors recovered; you're all fired! Doesn't anyone in stroke have two functioning neurons to rub together?

 Cognitive performance and stroke-specific quality of life four years after stroke

Marte Christine Ørbo^1*Oddgeir Friborg¹Audny Anke²Marianne Berg Halvorsen¹Mari Thoresen Løkholm³Synne Garder Pedersen⁴

• ¹Department of Psychology, UiT The Arctic University of Norway, Tromsø, Norway
• ²Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
• ³Department of Rehabilitation. The University hospital of North Norway, Tromsø, Norway
• ⁴Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway, Tromsø, Norway

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Long-term cognitive outcomes after stroke and their impact on health-related quality of life remain understudied. This study examined associations between cognitive performance and the Stroke-Specific Quality of Life scale (SS-QOL) four years after stroke. Sixty-five individuals (mean age 64 years, 74% male) with mild-to-moderate strokes completed the SS-QOL, the Modified Rankin Scale (mRS) and a neuropsychological test battery. A previously established principal component analysis of the SS-QOL informed division into Cognitive-Social-Mental (CSM) and Physical-Health (PH) components. Most participants reported no or mild disability on the mRS. Relative to age-adjusted norms, the group performed slightly below average across several cognitive domains, with marked variability indicating a subgroup with pronounced deficits. PH scores were high, reflecting minimal physical disability, whereas CSM scores were lower, indicating persistent challenges. CSM scores were associated with reaction time (ρ = .47), verbal memory (ρ = .42) and fine-motor coordination (ρ = .39; all p ≤ .001). PH scores were associated with fine-motor coordination (ρ = .49; p < .001). No significant associations emerged for language, visuospatial abilities, attention or executive functions after correction for multiple comparisons. In summary, associations between cognitive domains and SS-QOL were circumscribed and concentrated within the CSM component. Results indicate that cognitive and psychosocial factors are relevant in long-term recovery. Even selective cognitive deficits could reduce health-related quality of life and warrant follow-up. Generalisability is limited by the small, predominantly male sample, exclusion of individuals with aphasia, severe disability or age >75 years. Replication in larger, more diverse samples is needed.

Keywords: Stroke, Cognition, verbal memory, health-related quality of life, processing speed, Fine-motor coordination

Received: 07 Jun 2025; Accepted: 23 Sep 2025.

Copyright: © 2025 Ørbo, Friborg, Anke, Halvorsen, Løkholm and Pedersen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Marte Christine Ørbo, marte.c.orbo@uit.no

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