ABSTRACT NUMBER: ESOC2026A1327 MISMATCH BETWEEN SUBJECTIVELY AND OBJECTIVELY AFFECTED COGNITIVE DOMAINS LONG-TERM AFTER STROKE

Abstract Background and aims Subjective cognitive complaints (SCC) are common after stroke, yet their long-term relevance and associations with objectively measurable impairment remain unclear. We examined the relationship between subjectively reported and objectively assessed cognitive domains 36 (FU36) and 60 months (FU60) after ischemic stroke. Methods We conducted a cross-sectional single-centre sub-study within the multicentre DEMDAS cohort. Participants completed the Everyday Cognition Short Form alongside comprehensive neuropsychological testing. SCC were analysed as binary variable for each cognitive domain. Objective cognition was quantified using domain-specific mean z-scores. Group differences were assessed using Welch’s t-tests. Multivariable logistic regression models adjusted for age, years of education, stroke severity, domain-specific cognitive performance scores and depressive symptoms were applied to identify predictors of domain-specific SCC. Results We included 46 participants at FU36 and 67 at FU60. Subjective impairments were most frequently reported in language, memory and attention, whereas objective impairment was most common in attention, visuospatial abilities, and executive function. Participants reporting SCC in a domain had significantly lower corresponding domain-specific z-scores than those without SCC. Domain-specific z-scores were negatively but non-significantly associated with SCC, while depression severity was the only consistent independent predictor across cognitive domains and follow-ups in regression models. Conclusions Subjectively affected cognitive domains showed limited cross-sectional concordance with objectively measured domain performance three to five years post-stroke. Although SCC were associated with lower domain-specific z-scores, scores remained below diagnostic thresholds for cognitive impairment. These findings suggest that long-term SCC may be predominantly influenced by affective factors or reflect an early affective-cognitive syndrome. Conflict of interest All authors declare no conflicts of interest related to this project.