Understanding cognitive impairment after stroke: Stories from a middle-income country

Cognitive impairment (CI) is a common aftermath of stroke and associated with higher stroke burden due to its strong relationship with dementia and functional dependence. However, CI is usually underreported due to the prominence of physical disability represented by stroke. Cross-cultural studies on dementia have also demonstrated that the interpretations of dementia symptoms in different communities resulted in different ways of reporting and management strategies when confronted with symptoms. This study presents findings from a community of Malaysian-Chinese stroke survivors living in Malaysia on their understandings of cognitive deficits after stroke. The way stroke survivors thought about CI was also mediated by the cultural and social context that surrounded them. Of interest was the primacy of physical health over the cognitive which resulted in the invisibility of CI within this community, regardless of whether the deficits were mild or severe. Based on these findings, there is a need to rethink how cognitive decline should be observed in realistic community settings.