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Aims: To appraise the literature on long-term neuropsychological and functional outcomes in stroke survivors and identify the gaps, challenges and future research in this area., Background: Stroke care resources are scarce, and the number of stroke survivors is likely to increase with the ageing of the population. Thus, evaluating the cost, frequency and prognostic factors of long-terms stroke functional and neuropsychological outcomes is of paramount importance for evidence-based clinical decision making, including the rationale, planning, provision and allocation of health services, and the development of effective interventions. Summary of review Stroke has an enormous physical, emotional and economic impact on the patients, families and society. However, accurate data on frequency, relationship and predictors of various long-term functional (body functioning, activity and participation) outcomes and costs of stroke are scarce, and no accurate and comprehensive data exist on long-term neuropsychological outcomes and their relationships with other functional outcomes poststroke., Conclusions: There is a lack of accurate data on the frequency, relationship and predictors of various long-term functional outcomes and costs of stroke. There is a pressing need for good-quality population-based studies for evaluating the frequency and prognostic factors of long-term functional and neuropsychological outcomes of stroke in various populations.

Objective: Most scales that measure the ability of consumers with severe mental illness to function in community settings are designed to be completed by case managers or other clinicians. The objective of this study was to develop an instrument that could be completed by consumers., Methods: The 17-item clinician version of the Multnomah Community Ability Scale (MCAS) was adapted for use as a self-report instrument (MCAS-SR). An initial version of the MCAS-SR was reviewed for appropriateness and clarity by 20 consumers and four peer counselors and then revised. Test-retest reliability was studied with 37 consumers, and construct validity was examined in a correlational study of 288 consumers. Further validation involved correlations among consumer self-reports, case manager ratings, and ratings by research interviewers., Results: The instrument was acceptable to consumers; most consumers (80 percent) could complete it without assistance. The total score test-retest intraclass correlation was.91. Internal consistency was high (Cronbach's alphas greater than.80). The total score on the MCAS-SR was correlated with that on the Brief Symptom Inventory (Spearman's rho=-.59) and with that on the Mental Component Scale of the Short Form 12 (Spearman's rho=.61). The Spearman's rho correlation between consumer and case manager total scores was.41 for urban consumers and.21 for rural consumers. The correlation between consumer total scores and research interviewer total scores was.57 in the urban sample and.31 in the rural sample., Conclusions: The MCAS-SR is a reliable self-report instrument and can be valuable as an outcome measure and in treatment planning.