Cognitive, Functional, and Emotional Recovery in People with Stroke and TIA: A Multidimensional Prospective Analysis

Background: Stroke is a major cerebrovascular disease characterized by disrupted cerebral blood flow, leading to neuronal damage and significant physical, cognitive, and emotional sequelae. While advancements in acute stroke management have improved survival rates, long-term complications such as cognitive impairment and depression continue to hinder recovery. This study addresses these dimensions within the context of ischemic stroke and transient ischemic attack (TIA). Aim: To analyze the cognitive status, functionality, and depressive symptoms in people with ischemic stroke or TIA, exploring interrelations between cognitive, functional, and emotional outcomes to prioritize clinical interventions. Design: Analytical, observational, cohort, and prospective study. Methods: The study included 99 subjects diagnosed with ischemic stroke (n=81) or TIA (n=18) admitted to the Neurology Department of Lucus Augusti University Hospital. Data were collected at three time points—admission, discharge, and follow-up—using validated instruments such as the National Institutes of Health Stroke Scale, Mini-Mental State Examination, Barthel Index, and Beck Depression Inventory. Statistical analyses included Spearman's correlation, Kruskal-Wallis, and Mann-Whitney tests. Results: People with greater cognitive impairment at admission showed poorer functional recovery and higher depressive symptoms during follow-up. Depressive symptoms remained minimal in most cases, but correlations with cognitive and functional deficits were significant. NIHSS scores at admission strongly predicted both functional and emotional recovery, reinforcing its value in early prognosis and therapeutic planning. Conclusion: This study highlights the importance of integrating cognitive, functional, and emotional dimensions into stroke care protocols to optimize people recovery and improve long-term outcomes.