Objective:

This narrative review studies evidence on long-term cognitive and psychosocial outcomes post-stroke, with a focus on disparities and rehabilitation needs in diverse populations.

Background:

Post-stroke cognitive impairment and psychosocial challenges, including depression and social isolation, affect up to 30% and 40% of survivors, respectively, yet narrative reviews exploring these outcomes across diverse populations are limited. Racial/ethnic minorities and socioeconomically disadvantaged groups face worse outcomes, but the interplay of social determinants and long-term recovery remains poorly analysed.

Design/Methods:

A comprehensive review of literature (2015–2025) from PubMed, PsycINFO, and Google Scholar was performed, targeting studies on cognitive (e.g., MoCA scores) and psychosocial outcomes (e.g., PHQ-9 for depression, SIS-16 for social integration) in stroke survivors. Emphasis was placed on studies including underrepresented groups and social determinants of health (e.g., access to care, education). 

Results:

Cognitive deficits persist in 20–30% of survivors beyond 5 years, with depression rates highest in Black and Hispanic populations (40–50% vs. 30% in White populations). Socioeconomic barriers, such as limited rehabilitation access, exacerbate outcomes. Interventions like cognitive behavioral therapy show promise but lack tailoring for cultural or economic contexts.

Conclusions:

This review underscores the need for culturally sensitive rehabilitation programs and longitudinal studies to address disparities in post-stroke recovery. It calls for integrated care models prioritizing psychosocial and cognitive health.