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Semin Speech Lang 2023; 44(01): 015-025
DOI: 10.1055/s-0042-1759612
Review Article

Cognitive Profile in Patients Admitted to Intensive Rehabilitation after Stroke Is Associated with the Recovery of Dysphagia: Preliminary Results from the RIPS (Intensive Post-Stroke Rehabilitation) Study

Benedetta Basagni
1   IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
,
Sara Marignani
1   IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
,
Silvia Pancani
1   IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
,
Andrea Mannini
1   IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
,
Bahia Hakiki
1   IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
,
Antonello Grippo
1   IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
,
Claudio Macchi
1   IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
,
Francesca Cecchi
1   IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
2   Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
› Author Affiliations FUNDING For this study we received funding from the Italian Ministry of Health current research funds.
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Abstract

Dysphagia represents one of the most frequent symptoms in the post–acute stroke population. Swallowing impairment and cognitive deficits can often co-occur. This study aims to investigate the relationship between cognitive impairment and the recovery of dysphagia in patients attending specific rehabilitation. Patients admitted to intensive rehabilitation units were administered the Functional Oral Intake Scale (FOIS) and Montreal Cognitive Screening Test (MoCA); when screening positive for dysphagia, they entered a rehabilitation program. Their FOIS score at discharge was the primary outcome measure. In the multivariate analysis, younger age (B = − 0.077, p = 0.017), higher MoCA (B = 0.191, p = 0.002), and higher FOIS (B = 1.251, p = 0.032) at admission were associated with higher FOIS at discharge. When executive function (EF) replaced the MoCA total score in the model, younger age (B = − 0.134, p = 0.001), higher admission EF (B = 1.451, p < 0.001), and FOIS (B = 1.348, p = 0.035) were associated with higher FOIS at discharge. Our results confirm the hypothesis that a better cognitive profile upon admission is associated with a higher probability of dysphagia recovery at discharge. EF seems to have a crucial role in dysphagia recovery. These results highlight the importance of considering the cognitive profile when assessing and treating dysphagia after stroke and of using screening tests that include executive functions.

Keywords

dysphagia - rehabilitation - cognitive impairment - stroke - executive functions


Publication History

Article published online:
17 January 2023

© 2023. Thieme. All rights reserved.

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