Neuropsychological deficits and health care use among patients at risk for cerebrovascular accidents: A retrospective analysis of cases referred for evaluation.

Abstract

The association of risk for cerebrovascular accidents, severity of disease, and neurocognitive ability was examined in 58 veterans referred for neuropsychological assessment. Given the close association between health care utilization and cerebrovascular disease it was hypothesized that both health care use and stroke risk would account for a significant proportion of variation in scores on a battery of neuropsychological tests. Although age and education emerged as important predictors of neurocognitive ability, neither the use of medical resources or the level of risk added appreciably to the amount of variance explained by age and education alone. The failure to obtain the expected results was explained on the basis of the trend toward decreasing incidence of stroke, modification of risk through effective medical care, the small sample size, possible insensitivity of the neuropsychological measures, fragmentary psychodiagnostic information, and incomplete or inaccurate medical records.