Specific Impairment of Visual Attention and Swallowing in the Subacute Phase of Post-stroke: a Retrospective Cohort Study

Introduction: Post-stroke dysphagia affects a significant proportion of stroke survivors, with estimates suggesting that up to 50% experience swallowing difficulties following their event. While neurological damage from stroke is a well-recognized factor contributing to dysphagia, the relationship between cognitive impairment and the presence of dysphagia in post-stroke survivors is less clear. Therefore, we aimed to assess the correlation and the association between cognitive impairment and the presence of dysphagia in post-stroke survivors at 1 month. Methods: A retrospective observational cohort of stroke survivors treated from 2022 to 2024 underwent the Mann Assessment of Swallowing Ability (MASA) and the Oxford Cognitive Screen (OCS) 1-month post-stroke. Spearman’s partial correlations and multiple binary logistic regression analyses assessed whether a domain-specific cognitive impairment was associated with MASA scores. Results: A total of 48 stroke survivors were included; 20 subjects (10 males; mean age: 64.40 ± 11.93 years) were classified as non-dysphagic (Group 1); 28 subjects (12 males; mean age: 70.93 ± 10.19 years) were classified as dysphagic (Group 2). According to the cognitive profile subtests, there were increased severity of semantics (p=0.05), visual attention (i.e., broken hearts; p<0.001), executive functions (p<0.01); and praxis (i.e., imitating gestures; p=0.001) scores were correlated with higher scores at the MASA independent of age. Domain-specific impairment in visual attention (OR = 0.89, CI 95% 0.82 to 0.94, P < 0.001) predicted dysphagia in stroke survivors independent of age. Conclusion: Domain-specific cognitive impairments, specifically in attention and executive functions, were found to negatively impact overall swallowing function outcomes 1-month post-stroke.