Abstract Body: Background/Objectives:
More than 50% of stroke survivors experience at least one manifestation of “non-motor” impairment. These impairments impact daily functioning and are often under-recognized. We explored the feasibility of multifaceted assessments in an outpatient setting and the co-occurrence of these symptoms.

Design:
We performed a retrospective chart review of patients evaluated in a stroke behavioral and cognitive recovery clinic at a single tertiary care center. A vascular neurologist evaluated the patients and administered multiple assessments. Moderate to significant fatigue was defined by a score of 36 or higher on the Fatigue Severity Scale, depression by PHQ-9 ≥10, anxiety by GAD-7 ≥10 and, increased daytime sleepiness by Epworth Sleepiness Scale ≥10. A Communicative Participation Item Bank score of ≤17 indicated moderate or severe communication difficulties. Scores ≥3 on each of the 5 dimensions of the EQ-5D-5L describing health-related quality of life, indicate moderate to severe impairments. Descriptive analysis and chi-square tests were used to describe the cohort and the association of the different assessments.

Results:
Twenty-nine encounters were performed. The mean age was 57 years (SD = 11) and 66% were women. The mean NIHSS score at initial presentation was 6 (SD 7.25). Patients were evaluated at a mean of 18 months (SD = 19.4) post- stroke. Of all encounters 82% had at least one, and 62% had at least two moderate or severe “non-motor” symptoms. Post-stroke fatigue was observed in 15 (51.7%), depression in 10 (34.4%), anxiety in 16 (55.1%), increased daytime sleepiness in 10 (34.4%), and communication difficulties in 13 (44.8%) assessments. Moderate to severe impairments on items of the EQ-5D-5L were observed in mobility (31%), self-care (13.7%), usual activities (58.6%), pain/discomfort (34.4%), and anxiety/depression (51.7%). Significant associations were found between anxiety and depression (p = 0.006), anxiety and increased daytime sleepiness (p = 0.005), and anxiety and communicative difficulties (p=0.01). Figure 1 illustrates the distribution and overlap of these symptoms among all the encounters.

Conclusion: It is feasible to simultaneously assess multiple aspects of stroke patients’ experience in outpatient clinical settings using simple screening tools. “Non-motor” symptoms were common and often co-occurred. Quality of life was mostly impaired by difficulty doing usual activity and depression/anxiety.