Sex-Specific Role of Cognitive Reserve in Activities of Daily Living Recovery After Subacute Stroke.

Objective: This study aimed to investigate the association between cognitive reserve (CR), measured using the Cognitive Reserve Index questionnaire (CRIq), and activities of daily living (ADL) outcomes among patients with stroke during the subacute phase, focusing on sex-related differences in CR an...

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Publicado en:NeuroRehabilitation Vol. 57; no. 4; pp. 562 - 571
Autores principales: Choi, Young-Ah, Nam, So-Young
Formato: research tables/charts Journal Article
Publicado: Sage Publications Inc. Dec2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2025
      vid: 57
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        atl: Sex-Specific Role of Cognitive Reserve in Activities of Daily Living Recovery After Subacute Stroke.
      aug:
        au:
          Choi, Young-Ah
          Nam, So-Young
        affil: Department of Rehabilitation Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
      sug:
        subj:
          Sex Factors
          Cognition Evaluation
          Activities of Daily Living Evaluation
          Recovery
          Stroke Rehabilitation
          Human
          South Korea
          Male
          Female
          Middle Age
          Aged
          Retrospective Design
          Record Review
          Nonexperimental Studies
          Stroke Patients
          Tertiary Health Care
          Questionnaires
          Scales
          Semi-Structured Interview
          Nonparametric Statistics
          T-Tests
          Mann-Whitney U Test
          Chi Square Test
          Fisher's Exact Test
          Data Analysis Software
          NIH Stroke Scale
          Funding Source
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Objective: This study aimed to investigate the association between cognitive reserve (CR), measured using the Cognitive Reserve Index questionnaire (CRIq), and activities of daily living (ADL) outcomes among patients with stroke during the subacute phase, focusing on sex-related differences in CR and their impact on ADL recovery. Results: Ninety-six stroke patients admitted to a rehabilitation ward were included, with demographic and clinical data collected from medical records. No significant sex differences in baseline characteristics were observed. Based on CRIq scores, 70.8% of patients were classified at a medium CR level, with no significant sex difference in composite CRIq scores. However, men scored higher in CRI-Working Activity (CRI-WA), whereas women scored higher in CRI-Leisure Time (CRI-LT). Least Absolute Shrinkage and Selection Operator (LASSO) regression revealed that better functional outcomes at discharge were associated with younger age, higher cognitive reserve, greater initial ADL function, and better motor ability. Additionally, a significant interaction between sex and cognitive reserve indicated a sex-specific effect on ADL recovery. In sex-stratified analyses, CRIq was a significant predictor of Modified Barthel Index (MBI) at discharge in men, along with age, MBI at admission, and Fugl-Meyer Assessment for Upper Extremity (FMA-UE). Conversely, CRIq was not predictive in women, while FMA-LE and MBI at admission were significant predictors. Conclusion: CR is an independent predictor of ADL outcomes, particularly in men, suggesting a sex-specific effect during the subacute phase of stroke. These findings underscore the importance of CR in recovery and support the need for more personalized rehabilitation strategies.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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