Older adults with post-stroke cognitive impairment have multidimensional rehabilitation needs that may not always be expressed spontaneously or clearly, requiring a patient-centred, holistic, and cognitively appropriate approach.
Key Findings
Results
Three overarching themes of rehabilitation needs were identified among older adults with post-stroke cognitive impairment.
Theme 1: 'Shared and supported rehabilitation goals' — needs recognized by both patients and healthcare professionals.
Theme 2: 'Patient-identified needs beyond current support' — needs expressed by patients but not routinely addressed by the healthcare system.
Theme 3: 'Undisclosed concerns and potential health risks' — distressing concerns that participants hesitated or were unable to express openly.
Data saturation was achieved during data collection across 12 participants.
Results
Participants had rehabilitation needs spanning cognitive and physical recovery, symptom management, health education, emotional support, family involvement, social participation, and identity adjustment.
These needs were described as 'multidimensional' and not always expressed spontaneously or clearly by patients.
The study explored participants' understanding of cognitive impairment and rehabilitation, psychological responses, difficulties in daily life and treatment, experiences of seeking help, expectations of healthcare support, and hopes for future recovery.
Needs were identified through semi-structured interviews, allowing participants to describe their own experiences and priorities.
Results
A subset of participant concerns were undisclosed and represented potential health risks.
Theme 3 specifically captured 'distressing concerns that participants hesitated or were unable to express openly.'
This finding highlights that standard clinical assessment or direct questioning may not reveal the full scope of patient concerns in this population.
The qualitative descriptive approach was necessary to uncover these latent concerns.
Methods
The study sample consisted of 12 older adults with ischemic stroke and post-stroke cognitive impairment recruited from a tertiary hospital in Jiangsu Province, China.
Participants had a mean age of 72.3 ± 5.6 years.
10 participants were male and 2 were female.
Recruitment took place from May to July 2025 from the Departments of Neurology and Rehabilitation.
Data saturation was achieved during data collection, supporting the sufficiency of the sample size for qualitative inquiry.
Conclusions
Coordinated support across hospital, community, home, and family settings was identified as essential for continuity of care in this population.
The authors identified that current support structures did not routinely address all patient-identified needs.
Family involvement was highlighted as a key component of a holistic rehabilitation approach.
The findings called for integration of care across multiple settings to 'promote long-term independence and well-being.'
The study advocated for a 'patient-centred, holistic, and cognitively appropriate approach' as the framework for rehabilitation.
What This Means
This research suggests that older adults who develop thinking and memory problems after a stroke (called post-stroke cognitive impairment) have a wide range of rehabilitation needs that go well beyond what is typically offered in routine medical care. Using in-depth interviews with 12 patients (average age 72 years) at a hospital in China, researchers identified three categories of needs: those already recognized and addressed by healthcare teams, those expressed by patients but not routinely met, and those that patients were too hesitant or unable to voice at all. The hidden concerns were particularly notable because they represent health risks that standard clinical interactions might miss entirely.
The study found that patients' needs spanned physical recovery, cognitive rehabilitation, managing symptoms, learning about their condition, emotional support, staying connected socially, and coming to terms with changes in their sense of self. Crucially, many of these needs were not raised spontaneously by patients, suggesting that healthcare providers cannot rely on patients to self-report all of their concerns — especially when those patients have cognitive difficulties.
This research suggests that stroke rehabilitation programs should be redesigned to be more patient-centred and holistic, actively drawing out concerns that patients may struggle to articulate. It also highlights the importance of involving families and coordinating care across hospitals, community services, and the home environment to support recovery over the long term. The findings are particularly relevant for healthcare systems serving aging populations with increasing rates of stroke and dementia.
Feng P, Li X, Yao J, Zhu W, Luo X, Liang J, et al.. (2026). Rehabilitation needs of older adults with cognitive impairment following ischemic stroke: a qualitative study.. Annals of medicine. https://doi.org/10.1080/07853890.2026.2715257