Train-your-brain pilot community-based intervention after stroke: cognitive trajectory over 10-month follow-up

Abstract

Introduction: Stroke leads to cognitive impairments that affect survivors’ quality of life. This study aimed to assess the effectiveness of the Train-Your-Brain (TYB) pilot community intervention in cognitive outcomes among stroke survivors and caregivers at baseline, post-intervention, and 10-month follow-up. Methods: Thirty-one participants (20 stroke survivors, 11 caregivers) were evaluated. Cognitive functioning was measured using the Montreal Cognitive Assessment (MoCA) with analysis of subtest-level performances and Symbol Digit Modalities Test (SDMT). Results: Among stroke survivors, MoCA immediate recall scores maintained during the intervention, but declined 10-months later (p = 0.005). Analysis of the MoCA delayed memory subtest revealed a graded performance across different recall formats. Free recall and category-cued recall deteriorated over 10 months, while multiple-choice format recall remained stable. A slight improvement was observed in SDMT scores from pre-TYB to post-TYB, which was relatively maintained after 10 months. Caregivers demonstrated significant improvements in MoCA language and sentence repetition (p = 0.014) scores at 10-month follow-up. Conclusion: Our findings suggest that while the intervention may lead to short-term stabilization in cognitive functioning among stroke survivors, these gains may not be sustained over time. Persistent cognitive deficits underscore the need for ongoing and long-term support.