A stroke can affect the way your brain understands, organises and stores information. This is also known as cognition.

Here we explain the different ways a stroke can affect your cognition, the problems this can cause and what you can do about them. 

The information on this page can be accessed in the following formats:

On this page:

Why have my memory and thinking been affected?
Diagnosing cognitive problems
Types of cognitive problems after stroke
Are there treatments that can help?
What can I do about cognitive problems?
Tips for family and friends

Why have my memory and thinking been affected?

Problems with memory and thinking (cognitive problems) are very common after a stroke. 

Every second, you receive a huge amount of information from the world around you through your senses. Your brain has to understand, organise and keep the information you need. This is known as cognition.

Different parts of your brain work together to produce cognitive skills like thinking and memory. If one of those parts of your brain is damaged by a stroke, this can lead to cognitive problems.

There are different types of cognitive problems which can affect people in different ways.

Diagnosing cognitive problems after a stroke

When you’re in hospital, you should be assessed to find out if you have any cognitive problems. However, some cognitive problems are not easy to identify, and some might only be noticeable after you return home. You should be assessed again at regular intervals after you leave hospital.

Cognitive assessments

It’s likely that you’ll need to complete a cognitive assessment. This will tell you more about the problems you’re having and why they’re happening.

The assessment is usually done by a doctor, occupational therapist or sometimes a psychologist. It involves a lot of questions, which can make you feel like you’re taking an exam, even though you are not. The results of the assessment will help your stroke team decide the best way to help you. The findings should be explained to you.

You can find out more about how each type of cognitive problem is diagnosed and treated below.

Types of cognitive problems after stroke

There are several different types of cognitive problems. Read more about each one, and how it's diagnosed and treated:

Having cognitive problems does not mean that you have dementia. Many people worry about this, but dementia gets worse over time, whereas cognitive problems after stroke often get better. Find out more about vascular dementia.

Are there treatments that can help?

Cognitive problems are usually worst during the first few months after a stroke, but they can and do get better.

Problems are likely to improve most quickly over the first three months, as this is when your brain is at its most active, trying to repair itself. It’s still possible for problems to improve after this, but you may find that it takes longer. Recovery can continue at a slower pace for months or years.

Treatments for cognitive problems focus on ways to cope with the problems, rather than ‘fix’ them.

An occupational therapist can assess you and help you learn coping strategies. This may involve using aids to help you manage, such as writing in a diary or using labels and reminders. Or it may involve learning other techniques that can help you.

If your problems are quite specific or severe, you may be referred to a clinical neuropsychologist or clinical psychologist. These healthcare professionals specialise in the way the brain works.

Whether you receive treatment or not, your problems should continue to be monitored to make sure you get the support you need for them. Even if you do not need support straight away, you may once you’ve been discharged from hospital, so your doctor and stroke team should make sure that you get it.

What can I do about cognitive problems?

1.      Get some help

If you think you may be experiencing some of the problems described, the first thing to do is to speak to your GP. They will check if there is anything else that could be causing the problems, such as an infection or side effects of medication.  

Depression, anxiety and sleep problems are common after stroke, and can make you perform less well on cognitive tasks. So if you feel depressed, anxious, or have difficulty sleeping, then let your GP or occupational therapist know.

It’s easy for people, including doctors, to forget that there are effects of stroke you cannot see. So do not wait to be asked about them. If you’re finding it hard, tell someone. Make it clear how your problems are affecting you and ask what support you can get.

2.    Do not be too hard on yourself

Having cognitive problems after a stroke is not something you can control. Be patient with yourself. You’re not stupid, even though you may feel that way.

Allow yourself more time to get things done and do not expect too much of yourself. Brain injury is a serious condition that needs diagnosis and rehabilitation, in the same way you need rehabilitation after another type of physical injury, like a broken leg.

3.    Stay active

Being as active as you can may help with cognitive problems. It can also help with emotional problems like low mood and anxiety. If you can, try to aim for aerobic exercise that gets your heart beating and makes you slightly out of breath. This could be a sport like swimming or running, or you can try gardening or brisk walking.

Visit our Getting Active section for more ideas about being active after a stroke.

4.   Get enough rest

Fatigue is very common after a stroke. It can make it even harder to concentrate or remember things. Plan your day so that you balance being busy with taking breaks and resting. You’re not going to be able to take life at the same pace as you did before, at least not to begin with. Take breaks when you need to and make sure you get good quality sleep at night. It will help you to focus if you do.

Returning to work

Cognitive problems can take a long time to improve. If you go back to work too soon, you could find it more difficult than if you went back a little later. An occupational therapist can give you advice about the best time to go back to work. They can also talk to your employer about how they can support you when you do.

5.    Look into aids and equipment

There are aids and equipment that you may find helpful, especially for problems with memory. Your occupational therapist will be able to suggest some to you.

6.    Find ways to relax

Your mind needs to rest just as much as your body. Even small things like going for a short walk, listening to music or having a quiet moment to yourself in another room can help to calm your mind. Some people find mindfulness or meditation really helpful. Relaxing can be difficult if you have a busy home life, but it’s important to find a way to rest your mind when you get tired or frustrated.

7.    Tell people what’s going on

Cognitive problems are nothing to be embarrassed about. Tell people about them. Explaining how someone can help will make it easier for you both. This might include speaking slowly or writing things down. It will also stop them getting offended if you forget something or get distracted.

8.    Talk to someone who understands

Cognitive problems can affect your confidence and how you feel about yourself. Talking about it can really help. Many people find support groups useful, because you can talk about problems with people who are going through the same thing.

If you prefer not to join a group, try talking to a friend or family member who you feel comfortable with.

Tips for family and friends

It can be difficult to know how to help someone with cognitive problems, so here are some tips to help you.

Be patient

Someone might need longer to respond or carry out a task. This can feel frustrating if you’re trying to help. Let your friend or family member do things in their own time. If there’s something bothering you, explain the problem calmly and focus on what you can both do to make it better.

Be encouraging

Do therapy exercises with your friend or family member and think of ways to make them fun. Cooking a meal can be a good way to practise planning and problem-solving, for example. If progress is slow, it can be easy to think that things will never get better, so help them by celebrating all their successes, however small.

Give information in the right way

If your friend or family member is finding it hard to concentrate or remember things, you can help by giving information in a way that suits them, including:

  • Breaking tasks down into individual steps.
  • Giving simple instructions, one at a time, rather than a list of things to do.
  • Keeping it brief: they might not be able to follow a 20-minute update about your day. Just start with the main points.

Do not do everything for them

It’s natural to want to help, but it’s better to help someone do things on their own rather than do it all for them. So if they ask you what day it is, suggest they look at the paper to find out. You could help by preparing an activity, such as putting out the things they need. Tidy up and de-clutter the area. They may be able to dress themselves or make a sandwich, if they have the things they need and a clear space.

Help them get support

If someone needs more support, contact the GP or stroke team.