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Cognitive Assessment

Original Editor - Stacy Schiurring

Top Contributors - Stacy Schiurring, Jess Bell and Tarina van der Stockt  

Cognition Introduction

Cognition refers to the mental processes involved in acquiring, processing and using knowledge and understanding through thought, experience, and our senses. Cognition encompasses a wide range of mental abilities, including attention, memory, problem-solving, reasoning, planning and organising, verbal skills and communication abilities.

As the human nervous system is highly interconnected, it is difficult to isolate a discussion of one component from the rest of its neuronal network. This article focuses on the cognitive assessment, but aspects of the sensory and motor assessments are vital to a thorough and complete understanding of cognitive findings.

Optionally, review the following articles on the sensory and motor assessments for a holistic understanding of the rehabilitation assessment.

Cognition Neuroanatomy Review

Regional functions of the brain

Cognition arises from the intricate interactions of multiple brain regions, each contributing uniquely to various mental processes. The frontal lobes, particularly the prefrontal cortex, are essential for executive functions such as planning, decision-making, problem-solving, social reasoning, and inhibitory control. These regions also support working memory and goal-directed behaviour.[1] Situated posteriorly, the parietal lobes are key to spatial awareness, attention, and the integration of sensory input. The primary somatosensory cortex, located in the parietal lobe, processes tactile and proprioceptive information, while the parietal association cortex synthesises sensory data to support motor planning and spatial cognition.[2]

Significant areas of the brain related to cognition

The temporal lobes play a critical role in auditory perception, memory formation, and language comprehension. Within the medial temporal lobe lie the hippocampus, which is crucial for the formation of declarative memories and spatial navigation, and the amygdala, which processes emotional responses and influences memory through emotional salience.[3] Language processing involves distinct cortical areas, notably the Wernicke's area in the left posterior superior temporal gyrus, which manages language comprehension, and Broca’s area in the left inferior frontal gyrus, which is responsible for speech production and syntactic processing. These regions are connected by the arcuate fasciculus, a vital white matter tract enabling communication between language comprehension and production centres.[4][5]

The thalamus functions as a central relay, directing sensory and motor signals to appropriate cortical areas while also regulating attention, alertness, and consciousness.[6] The basal ganglia, a set of subcortical nuclei, are involved not only in motor control and procedural learning but also in cognitive processes such as habit formation, reward evaluation, and action selection.[7] At the posterior of the brain, the occipital lobes house the primary visual cortex, which processes essential visual features such as contrast, edges, and motion—this is fundamental for higher-level tasks such as reading and visual recognition.[8]

Lastly, the cerebellum, long associated with motor coordination, is now recognised as playing a role in higher-order cognitive functions, including attention, language, timing, and aspects of working memory. Collectively, this network of cortical and subcortical structures forms the anatomical and functional foundation for human cognition, allowing for the integration of sensory input, emotional context, and purposeful action.[9]

Please see the following articles for a more in-depth review of cognitive neuroanatomy:

Cognitive Examination

A cognitive examination is a vital component of a rehabilitation assessment, aimed at evaluating an individual’s mental functions, such as memory, attention, language, executive functioning, and orientation. Its primary purpose is to identify cognitive strengths and deficits that may impact daily functioning, safety, and the ability to engage effectively in rehabilitation therapies. Importantly, the outcomes of the cognitive assessment inform not only the cognitive rehabilitation plan but also influence the approach to motor and sensory assessment. A patient’s ability to follow instructions, retain new information, maintain attention, and engage in goal-directed activity directly affects the design and success of motor and sensory interventions. Therefore, understanding a patient’s cognitive profile is essential for developing personalised rehabilitation goals, facilitating appropriate care planning, and maximising the individual’s potential for functional recovery and independence.[10]

Testing procedure: Cognitive assessments should ideally be completed in a quiet room and be free from distractions. The patient should wear glasses or hearing aids as needed. The examiner should be positioned opposite or next to the patient. Cognitive assessments can be broken up into multiple sessions as indicated by patient ability and tolerance. Cognitive testing can include (1) formal assessments (2) the observation of self-care and activities of daily living (ADLs), or (3) interviews with the patient and/or care providers.[10]

The following sections overview cognitive domains by areas of general ability.[11]

Sensation and Perception

Sensation and perception are closely connected cognitive processes that shape how we experience the world. Sensation involves the detection of external stimuli via the sensory system; it is the initial stage where sensory organs collect raw data from the internal and external environments.[11] In contrast, perception is the cognitive process that organises and interprets this sensory input, allowing the brain to recognise and assign meaning to the information it receives.[12] While sensation supplies the essential data, perception enables the nervous system to understand and respond to it. Together, these processes form the foundation of our interactions with the world around us.[11]

Please review the sensory examination section of this article for in-depth information about different types of sensations and how they are tested.

Motor Skills and Construction

The domains of motor skills and construction encompass a person's ability to physically and cognitively interact with their environment. Motor skills involve the coordination and control of bodily movements and are typically divided into fine motor skills, such as hand-eye coordination, and gross motor skills, like running or jumping. These skills develop through practice and depend on the brain's ability to adjust actions based on sensory input. The construction domain involves cognitive abilities related to building or organising both physical structures and abstract ideas, relying heavily on spatial reasoning, planning, and problem-solving. Together, these concepts highlight the deep integration of physical ability and cognitive processing in daily functioning.[11]

Both of these domains are foundational to praxis skills, which is the ability to conceptualise, plan, and carry out motor tasks. Praxis includes understanding what needs to be done, forming a strategy, and executing it, as seen in activities like drawing or following a recipe.

Apraxia is the inability to perform skilled purposeful movements. There are four types of apraxia:[13]

  • ideational apraxia occurs when a person has difficulty planning and sequencing the steps of a task, even though the individual actions of the task are understood
  • conceptual apraxia is an impaired understanding of how to use objects correctly, despite intact motor skills and object recognition
  • ideomotor apraxia is the inability to carry out a motor action on command, though the person may perform it spontaneously in context
  • limb-kinetic apraxia occurs when a person has difficulty with fine, precise voluntary movements, often affecting one or more limbs

Attention and Concentration

Attention and concentration are essential cognitive functions that allow individuals to effectively engage with tasks and process information. Attention involves the brain's ability to selectively focus on specific stimuli while filtering out distractions. There are various forms of attention, such as sustained attention (maintaining focus over time), selective attention (focusing amidst competing inputs), and divided attention (managing multiple sources of information at once). Concentration, a component of attention, refers to the mental effort required to maintain focus on a task, often involving the ability to ignore distractions over extended periods.[11]

Both attention and concentration are influenced by internal and external factors, including motivation, fatigue, and the surrounding environment. These abilities are crucial for everyday tasks such as studying, driving, and engaging in social interactions, and they play a significant role in learning, decision-making, and memory. Attention supports listening comprehension and the ability to follow instructions, while concentration enables sustained cognitive effort, memory formation, and performance improvement in complex activities.[14][15]

Memory

Memory is a fundamental aspect of cognition that enables individuals to encode, store, and retrieve information, allowing past experiences, knowledge, and skills to inform present behaviour and decision-making. It is a complex system composed of several interrelated types, each serving a distinct function.[11]

Table 1. Categories of memory[11][16]
Type of Memory Subcategories Description Functional Example
Sensory memory
  • The first stage in the memory process, where information from the environment (such as sights, sounds, and smells) is briefly held for a fraction of a second
  • It acts as a filter, allowing us to momentarily retain sensory impressions before deciding whether to ignore them or transfer them to short-term memory
 You see the flashing light of a cross-signal light, sensory memory holds the impression for an instant, allowing you to process it further

(do I stop and wait, or is it safe to cross the street?).

Short-term memory

(STM)[17]

  • Holds information for a brief period, typically 15-30 seconds
  • Has a limited capacity (around 5-9 items)
  • Used for temporary storage
 You are able to remember the digits of a new phone number long enough to dial it correctly.
Working memory
  • A more active form of STM
  • It not only retains information but also manipulates it for cognitive tasks like reasoning, problem-solving, and comprehension
 You are able to calculate a tip at a restaurant in your head: holding the total bill amount in mind while mentally figuring out 20% and adjusting for what each person owes.
Long-term memory

(LTM)[17]

  • Involves information being stored for extended periods, from hours to a lifetime
  • Has virtually unlimited capacity
  • This type of memory is divided into explicit (declarative) memory and implicit (non-declarative) memory
Explicit memory

(declarative memory)

Explicit memory is the conscious recall of facts, events, and concepts, it is divided into three types.
  1. Episodic memory involves the storage of personal experiences and specific events. It allows individuals to recall details about events, places, and times.
  2. Semantic memory refers to the storage of general knowledge, facts, concepts, and meanings that are not tied to specific personal experiences; it is not context-dependent and doesn’t involve personal experiences but instead involves abstract facts and concepts we accumulate over time.
  3. Prospective memory refers to the ability to remember to perform future tasks or actions. It is divided into two main types: event-based (remembering to do something when a specific event occurs) and time-based (remembering to do something at a particular time).
 This type of memory requires both memory and attention to ensure that future actions are not forgotten.
  1. Episodic memory: you are able to remember the details of your graduation day (what you wore, who was there, and how you felt during the ceremony).
  2. Semantic memory: you are able to recall that Paris is the capital of France, even though you have never been there.
  3. Prospective memory: you are able to remember to take your medication at 8 p.m. each night without a reminder.
Implicit memory

(non-declarative memory)

Implicit memory involves information that is stored and accessed unconsciously.
  • Procedural memory is a type of implicit memory and involves the storage of skills, habits, and actions that are performed automatically or unconsciously.
 You are able to type on a keyboard without looking at the keys.

These different types of memory are closely related and form a cohesive system. Sensory memory filters and briefly holds incoming information, which then moves into short-term memory, where it is either discarded or further processed. Information that is deemed important may be encoded into long-term memory, where it can be stored and retrieved later. Long-term memory encompasses both explicit memories, like episodic and semantic memories, which are conscious and involve facts and personal experiences, and implicit memories, like procedural memory, which are learned skills and actions that are performed without conscious awareness. Prospective memory (a third type of explicit memory) helps guide future actions and integrates with both short- and long-term memory to ensure that we fulfil our goals and intentions.[18][16] [17]

These interconnected memory systems support complex cognitive tasks such as learning, problem-solving, and future planning. Memory performance is shaped by factors like attention, emotional relevance, and repetition, and it is susceptible to distortion or decline due to ageing, stress, or neurological conditions.[11] Understanding how memory operates offers valuable insight into how individuals learn, adapt, and navigate the challenges of everyday life.

Orientation

Orientation allows individuals to be aware of their surroundings, the passage of time, and their own identity. It encompasses four main aspects: (1) orientation to time (awareness of the current date, season, or year), (2) place (understanding one’s physical or contextual location), (3) person (awareness of self, personal roles, and relationships), and (4) event or situation (comprehension of recent events and their outcomes). These elements work together to help individuals navigate their environment, make decisions, and engage in meaningful interactions; people typically orient themselves automatically in familiar settings, but factors such as illness, injury, or cognitive decline can disrupt this process, leading to confusion or disorientation. Maintaining proper orientation reflects the integrity of the cognitive system and is essential for everyday tasks, such as driving or attending appointments, and more complex responsibilities that require situational awareness and self-understanding.[19]

Executive Functioning

Executive functioning refers to a set of high-level cognitive processes that enable individuals to plan, make decisions, solve problems, and regulate their behaviour to achieve goals. These skills include reasoning, problem-solving, working memory, emotional control, focus, task initiation, organisation, time management, prioritisation, goal-setting, flexibility, and stress tolerance. Executive functions coordinate thoughts and actions to manage tasks effectively, especially in complex or unfamiliar situations that require strategic thinking and adaptability.[11][20]

Closely linked to the prefrontal cortex, these cognitive abilities can be influenced by factors such as age, stress, and mental health. Impairments in executive functioning, seen in conditions like ADHD, brain injury, or neurodegenerative diseases, can severely impact daily life. Understanding executive functioning is crucial for recognising how individuals control and allocate their cognitive resources to navigate both routine and novel tasks.[20]

Processing Speed

Processing speed refers to the rate at which an individual perceives, interprets, and responds to information. It involves the brain's ability to quickly perform mental tasks, such as pattern recognition, problem-solving, or decision-making, and is essential for daily activities like reading, driving, and academic or professional tasks. Individuals with faster processing speeds can absorb and react to information more efficiently, enhancing learning and productivity. This cognitive function is influenced by factors such as age, neurological health, and attention levels. Processing speed typically declines with age or cognitive impairments, affecting one's ability to manage multiple tasks or respond rapidly in unfamiliar situations. However, it is important to note that processing speed does not equate to intelligence; instead, it reflects how efficiently cognitive tasks are executed. Slower processing speed can often be mitigated with additional time, strategies, or careful thought.[11][21]

Language and Verbal Skills

Language and verbal skills allow individuals to understand, produce, and manipulate spoken and written language, enabling effective communication and thought. These skills include processes like syntax (sentence structure), semantics (meaning of words), and pragmatics (social use of language). Verbal skills, a subset of language abilities, specifically focus on using words across speaking, listening, reading, and writing. Strong language and verbal skills are vital for academic success, problem-solving, and effective communication, while deficits in these areas can result in difficulties with speaking, reading, writing, and comprehension.[11]

The following paragraphs overview common disorders of language or verbal skills.

Aphasia is an acquired language disorder that can affect speaking, verbal understanding, reading, and writing. There are several kinds of aphasia based on the areas of the brain impacted. The three most common are: (1) Broca's aphasia (also known as non-fluent aphasia or expressive aphasia), which is characterised by difficulty in producing speech but language comprehension is often preserved. Speech tends to be slow, effortful, and grammatically simplified. The person may struggle with speaking full sentences or using the correct words but can understand speech well; (2) Wernicke's aphasia (also known as fluent aphasia or receptive aphasia) is when a person can speak fluently and with normal grammar, but their speech may lack meaning (they may say made-up words or jumbling words). The person will also have difficulty understanding spoken or written language; (3) Global aphasia is characterised by a near complete loss of language ability, meaning a person with this condition cannot speak, understand speech, read, or write.[22]

Anomia is a type of language disorder where a person has difficulty finding the “correct” words during speech, leading to frequent word-finding pauses or substitution of incorrect words. While people with anomia may understand language well and have normal speech fluency, they may struggle to name objects or people, resulting in vague or circumlocutory speech.[23] Circumlocutory speech is when a person “talks around” or describes something rather than directly stating what it is because they cannot recall its name.[24]

Dyslexia is a learning disorder that primarily affects reading,[25] and spelling.[26] It commonly occurs alongside other developmental disorders.[26] Persons with dyslexia may have difficulty recognising words, decoding written text, or spelling despite having normal intelligence and educational opportunities. Symptoms can include: difficulty reading quickly and accurately, trouble understanding written text, and problems with spelling and writing.[25]

Apraxia is a motor speech disorder that affects the ability to plan and coordinate the movements needed for speech. Individuals with apraxia may know what they want to say but have difficulty coordinating the muscles needed for speaking. This leads to inconsistent speech errors, such as difficulty pronouncing words correctly, and may include: (1) difficulty with articulation (eg. "dog" might sound like "gog"), (2) difficulty with sequencing sounds or syllables, and (3) effortful or groping movements to produce speech.[27]

Syntactical disorders are characterised by difficulties with the structure or grammar of sentences. This includes challenges in using the correct word order, tenses, or sentence structure. Individuals with syntactical disorders may produce sentences that are grammatically incorrect or hard to follow, even though they can understand language well.[28]

Pragmatics refers to the social use of language, including understanding the appropriate context for communication, taking turns in conversation, and interpreting non-literal meanings (like sarcasm). A pragmatic language disorder can affect a person's ability to initiate or maintain conversations, their understanding of social cues, such as tone or facial expressions, and limit the use of appropriate language in social contexts.[29]

Developmental language disorder (also known as a specific language impairment), is a condition where children have difficulties acquiring language despite having normal cognitive function and no hearing impairments. Children with a developmental language disorder may present with (1) delayed speech development, (2) difficulty with grammar and vocabulary, and or (3) struggle with both expressive and receptive language skills.[30]

Auditory processing disorder affects how the brain processes sounds and speech, even though hearing ability may be normal. Individuals with an auditory processing disorder may have (1) difficulty distinguishing similar sounds from each other, (2) have difficulty understanding speech in noisy environments, and (3) have trouble following verbal instructions.[31]

Fluency disorder disrupts the flow of speech, making it difficult to speak smoothly. Persons with fluency disorder may (1) repeat sounds, syllables, or words, (2) have prolonged sounds or pauses in speech, and / or (3) exhibit physical tension or struggle while speaking. While not strictly a "language" disorder, stuttering affects the fluency of speech and can sometimes occur alongside other language impairments.[32]

Cognitive Rehabilitation

A 2021 systematic review and meta-analysis[33] looked at the effectiveness of cognitive rehabilitation for patients with Parkinson's (PD). It found that memory is the most frequently targeted domain in cognitive rehabilitation studies, with working memory showing moderate and significant improvements, while verbal memory showed small but significant effects and visual memory showed small non-significant effects. Executive functions and processing speed were also commonly trained domains, with executive functions showing small significant improvements and processing speed showing small non-significant effects, though both domains had high variability in assessment measures. This was the first meta-analysis to examine verbal fluency in Parkinson's disease cognitive rehabilitation, finding small effect sizes with only one of six studies showing improvements, specifically in semantic fluency.[33]

Cognitive rehabilitation for patients following a cerebral vascular accident (CVA, stroke) is often a challenging task. Cognitive impairment following CVA affects multiple domains including memory, attention, executive function, language, and visuoperceptual ability.[34] These cognitive domains work together to enable complex mental processes that allow individuals to select and process information from their environment. Due to the interconnected nature of cognitive domains, interventions that treat multiple cognitive components showed positive effects on general cognitive functioning and memory outcomes. The additional of some form of physical activity may provide additional positive effects to treatment outcomes.[35] It is important to note that tasks that are functional and salient (meaningful) will have positive effects on neuroplasticity and effectivenss of treatment interventions.

Standardised Cognitive Assessments

The following articles provide in-depth information on specific cognitive assessments:

Resources

References

  1. ↑ Miller EK, Freedman DJ, Wallis JD. The prefrontal cortex: categories, concepts and cognition. Philosophical Transactions of the Royal Society of London. Series B: Biological Sciences. 2002 Aug 29;357(1424):1123-36.
  2. ↑ Souza-Couto D, Bretas R, Aversi-Ferreira TA. Neuropsychology of the parietal lobe: Luria’s and contemporary conceptions. Frontiers in Neuroscience. 2023 Oct 20;17:1226226.
  3. ↑ Patel A, Biso G, Fowler J. Neuroanatomy, Temporal Lobe [Internet]. 2023 [cited 07/May/2025]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519512/
  4. ↑ Javed K, Reddy V, Das J. Wroten M. Neuroanatomy, Wernicke Area [Internet]. 2023 [cited 07/May/2025]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK533001/
  5. ↑ Stinnett T, Reddy V, Zabel M. Neuroanatomy, Broca Area [Internet]. 2023 [cited 07/May/2025]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526096/
  6. ↑ Saalmann YB, Kastner S. The cognitive thalamus. Frontiers in systems neuroscience. 2015 Mar 17;9:39.
  7. ↑ Young C, Reddy V, Sonne J. Neuroanatomy, Basal Ganglia [Internet]. 2023 [cited 07/May/2025]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537141/
  8. ↑ Rehman A, Khalili Y. Neuroanatomy, Occipital Lobe [Internet]. 2023 [cited 07/May/2025]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK544320/
  9. ↑ Koziol LF, Budding D, Andreasen N, D’Arrigo S, Bulgheroni S, Imamizu H, Ito M, Manto M, Marvel C, Parker K, Pezzulo G. Consensus paper: the cerebellum's role in movement and cognition. The Cerebellum. 2014 Feb;13:151-77.
  10. ↑ 10.0 10.1 O'sullivan SB, Schmitz TJ. Physical rehabilitation: assessment and treatment. 1994.
  11. ↑ 11.00 11.01 11.02 11.03 11.04 11.05 11.06 11.07 11.08 11.09 11.10 Harvey PD. Domains of cognition and their assessment. Dialogues in clinical neuroscience. 2019 Sep 30;21(3):227-37.
  12. ↑ Tacca MC. Commonalities between perception and cognition. Frontiers in psychology. 2011 Nov 30;2:358.
  13. ↑ Gowda S, Hodis B, Schneider L. Apraxia [Internet]. 2024 [cited 09/May/2025]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK585110/
  14. ↑ Kelso I, Tadi P. Cognitive Assessment [Internet]. 2022 [cited 09/May/2025]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK556049/
  15. ↑ Oberauer K. Working memory and attention–A conceptual analysis and review. Journal of cognition. 2019 Aug 8;2(1):36.
  16. ↑ 16.0 16.1 Everyday Health. Types of Memory: Short-Term, Long-Term, Working Memory, and More. Available from: https://www.everydayhealth.com/brain-health/types-of-memory-short-long-working-memory-and-more/ (accessed 09/May/2025).
  17. ↑ 17.0 17.1 17.2 Cowan N. What are the differences between long-term, short-term, and working memory?. Progress in brain research. 2008 Jan 1;169:323-38.
  18. ↑ Mesulam MM. From sensation to cognition. Brain: a journal of neurology. 1998 Jun 1;121(6):1013-52.
  19. ↑ Cleveland Clinic. Mental Status Exam. Available from: https://my.clevelandclinic.org/health/diagnostics/mental-status-exam (accessed 09/May/2025).
  20. ↑ 20.0 20.1 Diamond A. Executive functions. Annual review of psychology. 2013 Jan 3;64(1):135-68.
  21. ↑ von Bastian CC, Reinhartz A, Udale RC, Grégoire S, Essounni M, Belleville S, Strobach T. Mechanisms of processing speed training and transfer effects across the adult lifespan: protocol of a multi-site cognitive training study. BMC psychology. 2022 Jul 8;10(1):168.
  22. ↑ National Institute of Deafness and Other Communication Disorders. Aphasia. Available from: https://www.nidcd.nih.gov/health/aphasia#types (accessed 09/May/2025).
  23. ↑ Cleveland Clinic. Anomic Aphasia. Available from: https://my.clevelandclinic.org/health/diseases/anomic-aphasia(accessed 09/May/2025).
  24. ↑ Veterans Disability Info. What is Circumlocutory Speech in Disabled Veterans. Available from: https://www.veteransdisabilityinfo.com/blog/what-is-circumlocutory-speech-in-disabled-veterans/ (accessed 09/May/2025).
  25. ↑ 25.0 25.1 International Dyslexia Association. Dyslexia Basics. Available from: https://dyslexiaida.org/dyslexia-basics/ (accessed 09/May/2025).
  26. ↑ 26.0 26.1 Carroll JM, Holden C, Kirby P, Thompson PA, Snowling MJ, Dyslexia Delphi Panel, Bagshaw S, Brackenbury G, Brigstocke S, Castiglione L, Daulby B. Toward a consensus on dyslexia: findings from a Delphi study. Journal of Child Psychology and Psychiatry. 2025 Feb 25.
  27. ↑ National Institute of Deafness and Other Communication Disorders. Apraxia of Speech. Available from: https://www.nidcd.nih.gov/health/apraxia-speech (accessed 09/May/2025).
  28. ↑ The Kingsley Clinic. Syntactic Disorder: Symptoms, Causes, and Treatment Options. Available from: https://thekingsleyclinic.com/resources/syntactic-disorder-symptoms-causes-and-treatment-options/ (accessed 09/May/2025).
  29. ↑ NHS Calderdale and Huddersfield. Pragmatic Language Impairment (PLI). Available from: https://www.cht.nhs.uk/fileadmin/site_setup/contentUploads/Services/Clinical/Children_s_Therapy_services/Childrens_Therapy/Speech___Language_Therapy/Pragmatic_Language_Impairment_information.pdf (accessed 09/May/2025).
  30. ↑ National Institute of Deafness and Other Communication Disorders. Development Language Disorder. Available from: https://www.nidcd.nih.gov/health/developmental-language-disorder (accessed 09/May/2025).
  31. ↑ Mayo Clinic. Auditory processing disorder (APD). Available from: https://www.mayoclinic.org/diseases-conditions/auditory-processing-disorder/symptoms-causes/syc-20555261 (accessed 09/May/2025).
  32. ↑ Johns Hopkins Medicine. Fluency Disorder. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/fluency-disorder (accessed 09/May/2025).
  33. ↑ 33.0 33.1 Sanchez-Luengos I, Balboa-Bandeira Y, Lucas-Jimenez O, Ojeda N, Pena J, Ibarretxe-Bilbao N. Effectiveness of cognitive rehabilitation in Parkinson’s disease: A systematic review and meta-analysis. Journal of personalized medicine. 2021 May 18;11(5):429.
  34. ↑ Jokinen H, Melkas S, Ylikoski R, Pohjasvaara T, Kaste M, Erkinjuntti T, Hietanen M. Post‐stroke cognitive impairment is common even after successful clinical recovery. European journal of neurology. 2015 Sep;22(9):1288-94.
  35. ↑ O'Donoghue M, Leahy S, Boland P, Galvin R, McManus J, Hayes S. Rehabilitation of cognitive deficits poststroke: systematic review and meta-analysis of randomized controlled trials. Stroke. 2022 May;53(5):1700-10.
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