Cognitive Impairments and Health System Outcomes in Inpatient Rehabilitation: A Comparison of Patients With Stroke and Those With Type II Diabetes Mellitus

Routine, diagnosis-agnostic cognitive screening identified high rates of cognitive impairment across diagnostic groups in IPR. Occupational therapy practitioners should incorporate systematic cognitive screening and follow-up functional cognition assessment to guide intervention planning and discharge preparation. Plain-Language Summary: Many people receiving inpatient rehabilitation experience problems with thinking and memory that can affect daily activities and recovery. These problems are often expected after stroke but may be overlooked in people with other health conditions, such as diabetes. This study compared cognitive impairment and rehabilitation outcomes in people with stroke and people with Type II diabetes who did not have a stroke. The study found that mild cognitive impairment was common in both groups, including many people with diabetes. Whether a person had a stroke or diabetes did not explain differences in functional outcomes or hospital readmissions. Instead, a person's functional ability at admission and overall health burden were more strongly related to outcomes. These findings suggest that occupational therapy practitioners should routinely screen cognition for all patients in inpatient rehabilitation, not only those with neurologic diagnoses. Early identification of cognitive challenges can support therapy planning, daily functioning, and safe discharge.