Systematic review of subjective memory measures to inform assessing memory limitations after stroke and stroke-related aphasia

Abstract

Aim

Primary aims of this systematic review were to: (1) identify the range of subjective memory measures used in the stroke and stroke-related aphasia literature and (2) critically appraise their psychometric properties as well as (3) the methodological qualities of studies that included them, (4) investigate whether such measures provide an accurate reflection of memory impairments (i.e., in comparison to norms from age-matched, neurotypical participants), (5) document the representation of individuals with stroke-related aphasia, and (6) examine the extent to which subjective memory measures correlate with objective memory measures.

Methods

Systematic review of the literature from 1970 to June 2019 using a comprehensive range of relevant search terms in EMBASE, Medline, PsychINFO, SCOPUS, and Web of Science. Eligibility criteria were for studies to include adults who had suffered of clinical stroke, to report a subjective memory measure that was completed by the stroke survivors, to be reported in a peer-reviewed journal, and to be published in English or Dutch. Quality appraisal was carried out for the included studies as well as the subjective memory measures they employed.

Results

A total of 7,077 titles or abstracts were screened, with 41 studies included in the quantitative and qualitative synthesis. Twenty-six subjective memory measures were used in the included studies. The critical appraisal of their psychometric properties and the methodological quality of the included studies revealed significant shortcomings; for example, neurotypical participants were included in only 14 of the 41 studies. When statistical comparisons were made, different outcomes arose. Only eight studies statistically compared subjective with objective memory measures.

Conclusions

This literature domain currently provides an unclear picture as to how memory limitations affect participation in stroke and stroke-related aphasia.

IMPLICATIONS FOR REHABILITATION

• A broad range of subjective memory measures have been used to determine stroke survivors’ perceptions of their everyday memory issues.

• Because of psychometric weaknesses such as inadequate reliability and cross-cultural validity among subjective memory measures, there remains a need to carefully review a given measure’s properties to determine if it is appropriate for use with a given stroke survivor.

• Stroke survivors with aphasia have been infrequently included or inadequately described in studies of subjective memory measures, and thus how these individuals perceive their everyday memory abilities requires further investigation.

• Although the relationship between subjective and objective memory measures has been infrequently investigated by stroke researchers, both types of measures should be considered as they likely offer complementary rather than redundant information about stroke survivors’ memory abilities.

Keywords:

• Stroke
• aphasia
• memory
• diagnostic self evaluation
• adult
• systematic review

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 One subjective memory measure was reported in French (Questionnaire de Plainte Cognitive; Thomas Anterion et al., 2003) but was included in the quality appraisal as its text was accessible to us.

2 The names of the measures are either those that were originally given by the authors of the measure or by us for measures that were not named by the authors to facilitate identification of the measure within this review.