Assessing Cognitive Function After Stroke Using the FIMTM Instrument*

Abstract

This study investigated the cognitive impact of stroke on an urban population. A total of 2,862 participants who had suffered a stroke during the past 10 years and had been admitted to a rehabilitation facility were included in the study. The average FIM score 64.44 on admission, 85.39 at discharge, and 98.16 at 6-month follow-up. The average FIM Cognitive subscale score at admission was 22.32, 25.56 at discharge, and 29.94 at follow-up. It was found that 24% of patients showed no improvement in cognitive scores between admission and discharge. After discharge, 36.2% showed no improvement in cognitive function at 6 months as determined by the FIM instrument. Overall, 17.4% of people showed no cognitive improvement between admission and follow-up. Differences in cognitive function levels were identified for age, gender, and marital status, although not for ethnicity. The implication of these findings is that a large proportion of stroke survivors show little, if any, improvement in their cognitive function after stroke despite vigorous rehabilitation. This demonstrates a continued need for nurses to identify strategies and interventions for improving cognition, minimizing the effect of cognitive deficits on the person and family, and establishing ways to maximize the quality of life for all concerned.