Assessing Prospective Memory after Stroke: a Comparison of Self-Report and Performance-Based Measures

ABSTRACT

Objective

Prospective memory (PM) is essential for daily functioning, allowing individuals to remember planned actions while engaged in other tasks. PM deficits can significantly affect quality of life, particularly in clinical populations, such as patients with stroke. The present study aimed to compare PM failures between patients with stroke and healthy controls using both a performance-based task and a self-report measure.

Method

Thirty-five patients with stroke and forty healthy controls participated in the study. All participants completed the Prospective scale of the Prospective and Retrospective Memory Questionnaire (PRMQ) and the event-based task from the Miami Prospective Memory Test (MPMT_event).

Results

Patients with stroke were significantly more likely to exhibit impaired performance on the MPMT_event than healthy controls. However, no significant differences were observed between the two groups in PRMQ scores. This finding indicates that, despite their lower performance on MPMT_event individuals with stroke did not subjectively perceive a higher frequency of PM failures in everyday life than healthy controls.

Conclusions

These findings suggest a dissociation between objective PM performance and self-assessment in patients with stroke, highlighting the role of metacognitive awareness. A lack of such awareness could hinder the adoption of effective strategies to improve PM performance. These results emphasize the need for a comprehensive assessment of PM that integrates both performance-based and self-reports measures to fully capture deficits in patients with stroke.

INTRODUCTION

Prospective memory (PM) refers to the ability to remember to carry out an intended action while engaged in other activities. This cognitive function requires conscious monitoring of the external environment to detect the right stimulus or appropriate moment, along with the ability to retrieve the intention associated with the planned action (Burgess et al., 2007; Cabeza, 2008; Corbetta & Shulman, 2002).

PM can be categorized as time-based, event-based, and activity-based (Shum et al., 1999). Time-based PM requires that an action be performed at an appropriate time in the future (McDaniel & Einstein, 2007), whereas event-based PM requires an action to be performed upon the occurrence of a particular event (Hogan et al., 2020b).

The proper functioning of PM is vital for maintaining independence in daily life, as it enables individuals to carry out various essential everyday activities, such as taking medication on time or attending scheduled appointments. It is worth noting that individuals complain about PM more often than about retrospective memory (Baddeley, 1997). Disruptions in this type of memory can be one of the most disabling factors affecting daily activities, not only in the aging population but also in persons with specific clinical conditions. In fact, patients with brain injuries, neurological alterations, and psychological disorders experience a deterioration of PM, which significantly affects their quality of life (Costa et al., 2008; Costa et al., 2011; Henry, 2021; Hernandez Cardenache et al., 2014; Hogan et al., 2016; Lecouvey et al., 2019; Niedźwieńska et al., 2017; Ordemann et al., 2014; Shum et al., 2011; van den Berg et al., 2012).

Currently, measures used to assess PM in clinical and research contexts include performance-based PM tasks and self-report questionnaires. It is worth noting that performance-based PM measures often fail to capture the complexity of everyday functioning. These tasks are administered in non-ecological contexts, over short retention intervals, and lack self-generated intentions, such as remembering to tell a friend a joke just heard (Shum et al., 2002). Conversely, PM self-reports are thought to have greater ecological validity (Phillips et al., 2008) as they provide insight into, e.g., the self-awareness, strategies used, and retrieval cues associated with PM in real-world activities (Chau et al., 2007). Several studies have found that correlations between self-reported and performance-based measures of PM are generally not significant. Indeed, although self-reported measures of PM reflect performance-based PM to some extent, the observed relationships are mostly weak or moderate in strength (Buchanan, 2017; Thompson et al., 2015; Uttl & Kibreab, 2011). It may be the case that the methodology used, along with variability in sample composition and size across studies, limits the robustness of the conclusions (Sugden et al., 2021). A key difference between the two measures concerns the use of memory aids: performance-based PM tasks often exclude tools commonly used in daily life (e.g., written reminders for medication), whereas self-reported PM studies showed that such tools are widely used (e.g., Evans et al., 2003; Jamieson et al., 2015). In addition, differences between the two measures may arise from cognitive and non-cognitive factors, including beliefs and stereotypes about aging and memory, that influence self-reported responses.

As highlighted in Sugden et al. (2021), although performance-based measures of PM have revealed PM impairments in patients (e.g., Hogan et al., 2016; Shum et al., 2011), only a few studies have directly compared patients with healthy control groups on self-report measures of PM.

Although the data presented in the literature are inconsistent, it can be deduced that combining the two approaches and comparing the performance of patients and healthy subjects could provide a more comprehensive assessment of PM.

In the clinical setting, there has been an increasing interest in understanding how PM is affected by stroke, although studies are still limited. Evidence indicates that stroke can be considered a risk factor for the onset of the PM deficits (Hogan et al., 2020b; Kant et al., 2014). For instance, Zhuang et al. (2021) found that PM deficits were associated with dorsal prefrontal cortex lesion, a crucial area for retention and monitoring processes. Similarly, Cheng et al. (2010) reported that thalamic lesions negatively impacted subjects’ performance on time-based PM tasks.

Furthermore, research on PM after stroke using self-report methods remains limited and has produced inconsistent results. A scoping review (Hogan et al., 2016) noted that several self-report studies found no significant differences in PM difficulties reported by patients with stroke compared to healthy controls (Brooks et al., 2004; Miller & Radford, 2014). In research where performance-based tasks have been combined with self-reports measure, a dissociation a has been observed between these two measures: patients tend to overestimate their PM abilities compared to their actual performance. This inconsistency likely reflects a reduction in self-awareness (Hainselin et al., 2021; Man et al., 2015). However, the amount of studies which compared in patients with stroke the objective performance with the self-assessment of prospective memory is very limited (Hainselin et al., 2021; Man et al., 2015). Furthermore, these few studies have been conducted in chronic patients (more than 6 months after the stroke).

Based on the above, the aim of the present study was to explore whether—and to what extent—patients with stroke and healthy controls differ in PM failures, as reported in self-assessment measures and performance-based tasks. Specifically, we aimed to investigate whether a discrepancy exists between self-reported and objectively measured prospective memory in subacute patients with stroke (Bernhardt et al., 2017), given that previous studies on this topic have focused on the chronic phase.

Investigating the discrepancy between self-assessment and objective measure in the sub-acute phase is particularly relevant to better address the rehabilitation programs. Reduced or impaired self-awareness may impact on the effectiveness of the interventions, as the awareness of one’s own memory failure is essential for seeking and aiding rehabilitation. Thus, PM self-assessment measures play a crucial role in both research and clinical practice. These measures may assess the individuals’ beliefs about their PM abilities, the impact of PM failures on daily functioning, and the outcomes of rehabilitation programs (Fleming et al., 2017).

MATERIALS AND METHODS

Participants

Thirty-five patients with stroke (18 women; mean age 70.5 years, range 45–86 years) were prospectively recruited between April 2023 and July 2024 at the Neuromotor Rehabilitation Unit of IRCCS Fondazione Don Carlo Gnocchi (Florence, Italy). The study was performed according to the Declaration of Helsinki and was approved by the local Ethics Committee of the “Area Vasta Centro – Regione Toscana” (approval number: 24044_oss) in Florence. This study was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines (von Elm et al., 2007). All participants provide a written informed consent to participate in the study.

The main inclusion criteria were: (1) Age ≥ 18 years; (2) first-ever ischemic or haemorrhagic stroke, diagnosed clinically and confirmed by brain imaging scan in the acute phase, (3) within 3 months from the index event (early subacute phase according to Bernhardt et al., 2017), (4) first-ever admission to the rehabilitation centre for the considered condition; (5) Italian mother tongue. Patients were excluded from the study if they met any of the following criteria: (1) cognitive impairment (Mini-Mental State Examination, MMSE raw score < 21); (2) presence of aphasia at the onset of evaluation; or (3) severe acquired brain injury, due to a haemorrhagic or ischemic stroke causing disorders of consciousness and critical clinical care conditions. We adopted a cut-off score of MMSE <21 to exclude patients with moderate to severe cognitive impairment, thus including only those with mild or no impairment (Carotenuto et al., 2018).

A control group of 40 healthy volunteers (25 women; mean age 71.2 years, range 47–87 years) was recruited from senior community centres. Exclusion criteria for healthy controls (HCs) were: (1) presence of cognitive impairment (Mini-Mental State Examination, MMSE raw score < 21); and (2) history of neurological and psychiatric disorders, or alcohol and substance abuse.

Cognitive and Neurological Assessment

All participants underwent a cognitive screening assessment using the Italian version of the Oxford Cognitive Screen (OCS; Demeyere et al., 2015; Mancuso et al., 2016), which evaluates five cognitive domains: Attention and executive function, Language, Memory, Number processing, and Praxis.

In addition, stroke severity for patients was determined using the National Institutes of Health Stroke Scale (NIHSS; Ortiz & Sacco, 2008), which assesses neurological deficits such as consciousness, gaze, visual fields, facial movement, motor and sensory function, limb ataxia, neglect, dysarthria, and language skills. Higher scores reflect more severe degrees of impairment.

Prospective Memory Assessment

All participants completed the Prospective scale of the Prospective and Retrospective Memory Questionnaire (PRMQ; Smith et al., 2000; Crawford et al., 2003), a self-report questionnaire used to evaluate subjective memory complaints. The PRMQ-Prospective scale consists of eight items, each rated on a 5-point Likert scale ranging from 5 (“very often”) to 1 (“never”), indicating how often each of the listed everyday memory failures occurs (total score range 8–40). Higher scores indicate more frequent memory failures. During data collection, clinical participants were instructed to complete the PRMQ based on their experiences since the stroke.

The internal consistency of the Prospective scale estimated by the Cronbach’s α was 0.84 (Crawford et al., 2003). Moreover, good construct validity and test–retest reliability have been demonstrated across different translated versions of the PRMQ (Blondelle et al., 2020; Gondo et al., 2010; González-Ramírez & Mendoza-González, 2011; Guerdoux-Ninot et al., 2019). Notably, in the recent French version (Guerdoux-Ninot et al., 2019), convergent validity of the PRMQ Prospective scale was supported by strong correlations with cognitive difficulties (r = .78), as well as weaker correlations with anxiety (r = .48) and depression (r = .23). Test–retest reliability was also satisfactory (r = .80).

The behavioural assessment of PM was conducted using a slightly modified version of the event-based task of the Miami Prospective Memory Test (MPMT_event; Hernandez Cardenache et al., 2014). The examiner placed an envelope on the table near the subjects and instructed them that when they heard an alarm, they should open the envelope, select one of the coloured cards (banknotes in the original test) to give to the examiner, and keep the other for themselves. The timer was set for 30 min. During the interval between the instructions and the alarm, the OCS was administered.

Participants’ responses were evaluated across three dimensions: (i.e., Intention to Perform, Accuracy of Response, and Need for Reminders. Each dimension was assigned a score from 0 to 3. The Intention to Perform measured whether the participant spontaneously acted, verbally acknowledged the need to act, provided a non-specific response, or made no response at all (3 = participant spontaneously takes the envelope when the timer sounds; 2 = participant does not take the envelope but verbally indicates awareness of needing to do something in response to the signal ̶ e.g., “I know I have to do something, but I don’t remember what”); 1 = participant gives a non-specific, non-verbal response to the signal ̶ e.g., looks around the room, looks at the area where the timer sounded; 0 = No response to the signal). Accuracy assessed whether the participant correctly selected and used the coloured cards (3 = participant correctly selects and gives the two cards of correct colors; 2 = participant selects the two cards of correct colors but uses them incorrectly; 1 = participant correctly selects only one of the two cards but mistakes the other; 0 = participant fails to select either card correctly). If no response occurred within 60 s, up to three cues were provided. Need for Reminders was scored based on how many reminders were required to elicit a response (3 = no prompts needed; 2 = needs only one prompt; 1 = needs two prompts; 0 = Needs three or more prompts).

The total score for the event-based task ranged from 0 to 9, with a cut-off score of 5 or below indicating deficient performance. This cut-off was applied uniformly to all participants, irrespective of gender, age, or education level (Hernandez Cardenache et al., 2014).

The MPMT incorporates several features that enhance its ecological relevance compared to traditional laboratory-based measures. First, the event-based component requires participants to remember and execute intentions after meaningful delay while engaged in other ongoing cognitive and social tasks, better approximating real-world prospective memory demands. Second, the use of concrete, everyday materials (e.g., card, clock, managing envelopes) and realistic instructions provides a context that mirrors common daily activities. Finally, the scoring system—including intention to perform, accuracy, and need for reminders—captures different levels of self-initiated retrieval and cue utilization, allowing for a more nuanced assessment of prospective memory performance in situations that simulate everyday challenges.”

Data Analysis

The dependent variables, MPMT_event scores and PRMQ-Prospective scale, were first tested for normality and equality of variance. Normality was assessed using the Shapiro–Wilk test for each group separately, and the equality of variance was examined using Levene’s test. The results indicated that the assumption of normality was violated for MPMT_event total scores in both groups (patients with stroke: p = .013; healthy controls: p < .001), while PRMQ-Prospective scale scores met the normality assumption (p = .312; p = .066). The assumption of equality of variance was confirmed for PRMQ-Prospective scale scores (p = .214), whereas it was violated for MPMT_event total scores (p < .001). Overall, the MPMT_event scores showed limited variability at both the domain and total score levels (Figs. 1 and 2), particularly in the control group. Namely, healthy participants exhibited a pronounced ceiling effect (with 72.5% and 15% scoring 9 and 8, respectively), resulting in a highly skewed distribution. To address this distributional limitation, we employed a categorical approach in which the data were dichotomized based on the established cut-off of ≤5 (Hernandez Cardenache et al., 2014). A log-Poisson regression analysis was then conducted to estimate the prevalence ratio (PR) with 95% confidence intervals (CI), quantifying the relative prevalence of impairment (total score ≤ 5) on the MPMT_event in patients with stroke compared to healthy controls. Moreover, robust variance estimation was applied (Zou, 2004).

To explore the potential influence of sample characteristics, age, gender, and education were included in the regression model. Each factor was then added to the model one at a time.

Similarly, to rule out the possibility that differences in the MPMT_event could be accounted for by a broader deficit in the episodic memory domain, performance on the OCS memory subtests was also added in the regression model. Namely, patients and controls were categorized based on their performance on the “Recall and Recognition” and “Episodic Memory” subtests of the OCS. A broader memory impairment was considered present when a participant scored below the cut-off on both subtests. The cut-off values used for the OCS memory subtests are those derived from the Italian normative data provided by Mancuso et al. (2016).

Between-group differences in PRMQ-Prospective scale scores were examined using independent-samples t-tests, with effect sizes reported as Cohen’s d. First, PRMQ-Prospective scale scores were compared between patients with stroke and healthy controls. Second, comparisons were conducted between patients with and without impairment on the MPMT_event. In addition, we applied the categorical approach using log-Poisson regression also to estimate the relative prevalence of high PRMQ–Prospective scale scores among patients with and without MPMT_event impairment and healthy controls. To the best of our knowledge, no established cut-off exists for the PRMQ. A Taiwanese study (Hsu et al., 2014) identified a cut-off of 16.5 to detect dementia; however, this value was derived from the proxy version of the PRMQ (i.e., the caregiver-completed questionnaire) and is therefore not directly comparable to the self-report version used in the present study. In the French validation study (Guerdoux-Ninot et al., 2019), the optimal cut-off to distinguish patients with memory complaints but no cognitive impairments from control participants was 21 on the Prospective Memory subscale. In our sample, the maximum observed PRMQ raw score was 21 (see Fig. 1), therefore, to allow a meaningful categorical analysis, we additionally dichotomized PRMQ–Prospective scores using the 75th percentile observed in the control group (75th percentile = 18).

All statistical analyses were conducted using JASP (Version 0.16.3; JASP Team 2022), except for the log-Poisson regression with robust variance estimation, which was carried out in R (version 4.5.1). Statistical significance was set at p < .05.

RESULTS

Demographic and clinical data are presented in Table 1. Age and education did not differ between the two groups when compared by the independent sample t-test (p = .778 and p = .371, respectively). The number of participants with a pathological score in each domain of the OCS is given in Table 2, along with the relative prevalence ratios estimated from the regression models.

The Poisson regression model with robust standard errors was fitted to estimate the association between group (patients with stroke vs. healthy controls) and impairment on the MPMT_event (defined as scoring ≤ 5). The model showed that patients with stroke had a significantly higher prevalence of impairment compared to controls (β = 2.2736, SE = 0.7108, z = 3.1986, p = .0014).

When defining impairment as a score ≤ 5 on the MPMT_event, 17 out of 35 patients with stroke (48.6%) and 2 out of 40 controls (5%) were classified as impaired. Expressed as a prevalence ratio, patients with stroke were 9.71 times more likely to be impaired than healthy controls (PR = 9.71, 95% CI [2.41–39.13]).

No significant effects of sample characteristics were observed in the regression model: age (β = 0.0282, SE = 0.174, z = 1.626, p = .104), gender (β = 0.6460, SE = 0.3748, z = 1.723, p = .085), or education (β = −0.0633, SE = 0.0410, z = −1.543, p = .123).

Similar results emerged when participants who had scored below the cut-off in both memory subtests of the OCS were considered in the regression model (17 among patients with stroke and 3 among healthy controls; β = −0.3633, SE = 0.3413, z = −1.065, p = .287).

No significant differences were found between patients with stroke and healthy controls in PRMQ-Prospective scale scores (t_1,73 = 0.619, p = .538; Cohen’s d = 0.143). Similarly, PRMQ-Prospective scale scores did not significantly differ within the patient group between those with and without impairment on the MPMT_event (t_1,33 = 1.828, p = .077; Cohen’s d = 0.618). Notably, when PRMQ–Prospective scores were classified using the clinically meaningful cut-off of 21 (Guerdoux-Ninot et al., 2019), none of the patients in the subgroup with stroke and impaired MPMT_event performance exceeded the cut-off (0/17), compared with 3/18 patients without MPMT_event impairment and 4/40 healthy controls. Using the 75th percentile observed in the control group as the cut point, 6/35 patients (1/17 and 5/18 among patients with and without MPMT_event impairment, respectively) and 13/40 controls reported PRMQ–Prospective scale scores ≥18. No significant effect emerged in the Poisson regression model (Table 3).

DISCUSSION

The present study aimed to examine PM in patients with stroke. To this end, the Prospective scale of the PRMQ, the event-based task of the MPMT, and an ongoing task – the OCS – were used to compare patients with stroke with a control group of healthy individuals. This approach allowed to evaluate both objective performance and self-report PM measures. The comparison between objective and subjective measures is crucial for enhancing the understanding of PM deficits after stroke (Hogan et al., 2020a, 2021; Shum et al., 2002). It is worth noting that only a handful of studies have examined this aspect (Crawford et al., 2006; Hogan et al., 2020b; Man et al., 2011; Uttl & Kibreab, 2011).

A significant difference was observed between the two groups in the performance-based assessment using the MPMT_event, with patients with stroke showing a higher prevalence of impairment than healthy controls. Patients scored lower than healthy controls across all event-related task measures (i.e., “intention to perform”, “accuracy of response”, and “need for reminders”), supporting the idea that stroke may significantly impair PM. Our results are consistent with previous studies demonstrating PM deficits in patients with stroke (Hogan et al., 2016, 2020a; Kim et al., 2009; Man et al., 2015; Miller & Radford, 2014). The PM deficits observed in this study are unlikely to be accounted for by a broader deficit in the memory domain, as the group differences remained significant even after considering performance on the OCS memory subtests. Furthermore, in the regression model age was not a significant predictor, in line with previous studies showing that event-based PM performance was not influenced by age (Einstein et al., 1995; Einstein & McDaniel, 1990; Henry et al., 2004) and in disagreement with studies which found a weak negative relationship between age and PM performance (Kamberis et al., 2021; Sullivan et al., 2022; Zuber et al., 2025). The lack of an age effect on PM performance may be linked to the test we used since cross-sectional studies evidenced an age-related decline in objective performance particularly when PM is assessed in laboratory settings (for meta-analyses and overviews, see Henry et al., 2004; Horn & Freund, 2021; Ihle et al., 2013; Kliegel et al., 2016; Zuber & Kliegel, 2020).

Contrary to the evidence from the performance-based test, no significant differences were found in PRMQ-Prospective scale scores. In fact, despite the objective deficits observed in patients with stroke, their self-assessment of PM in daily life does not differ from that of the control group. In addition, no correlation emerged between performance-based and self-report measures, suggesting that patients’ subjective perception of their PM abilities does not correspond with their actual performance, as they tend to overestimate their abilities. This finding aligns with previous research highlighting a lack of awareness in some individuals with stroke regarding their own PM abilities (Brooks et al., 2004; Kim et al., 2009; Man et al., 2015). Reduced awareness of memory failures in daily life may play a crucial role in maintaining these deficits. Individuals with acquired brain injuries often struggle to accurately perceive their impairments and recognize how these impairments affect their daily functioning (Caldwell et al., 2014; Villalobos et al., 2020; Yeo et al., 2021), suggesting a deficit at the metacognitive level. Metacognition is defined as the cognitive ability to self-regulate and reflect on one’s mental processes. It enables individuals to analyze and modify their behavior based on ongoing performance and shifts in internal states (Frith, 2012).

In fact, effective PM relies on metacognitive factors, such as the ability to monitor one’s performance, estimate how much information can be retained, and recognize when to use memory aids (Knight et al., 2005:). Smith (2016) argued, within her meta-intentional framework, that metacognitive processes—such as selecting strategies based on past experience—are an inherent component of prospective memory (PM). Research showed that individuals with a good awareness of their own PM abilities are more likely to adopt effective strategies for remembering their intentions (Cottini et al., 2018; Gilbert, 2015; Rummel & Meiser, 2013; Smith, 2016). Conversely, those with low awareness may select maladaptive or insufficient strategies that lead to more frequent memory lapses. However, awareness is only one of the factors influencing the strategies adopted to remember. The significance of the intention and the potential consequences of forgetting are also likely to play a role in how people approach remembering their intentions (Meeks et al., 2007). Multiple studies (e.g., Einstein et al., 2005; Smith & Bayen, 2004; Rummel & Meiser, 2013; Cowan, 2017; Kuhlmann, 2019) consistently indicate that strategic use of attention works together with retrospective memory to effectively detect event-based cues.

In this context, a lack of awareness regarding PM difficulties is likely to have a detrimental impact on performance, as individuals may fail to allocate the necessary preparatory attention to recall their intentions, particularly in circumstances where distractions render the task more challenging (Cottini et al., 2018; Gilbert, 2015; Rummel & Meiser, 2013; Smith, 2016). Consistent with this view, overestimating accuracy is associated with worse performance on objective measures of executive functioning in chronic stroke populations (Jaywant et al., 2022; Rotenberg-Shpigelman et al., 2014).

The findings indicate that patients with brain injuries tend to overestimate their memory abilities, showing greater confidence in their PM performance than is objectively supported by objective tests. This could suggest that in the context of aging and rehabilitation, interventions aimed at enhancing awareness of their capabilities could be more effective than focusing solely on improving PM performance (Gilbert, 2015; Knight et al., 2005; Rummel & Meiser, 2013; Smith, 2016).

One strength of this study is that it highlights that the poor metacognitive awareness of prospective memory deficits in patients with stroke in the sub-acute phase may negatively impact the rehabilitative practices typical of this phase (Ownsworth & Clare, 2006). Namely, the evidence that the gap between self-assessment and objective performance is already present in the subacute phase allows for better planning of the rehabilitation process, enabling early intervention on metacognition, which provides a foundation for subsequent rehabilitation.). In fact, a lack of awareness of one’s own cognitive failures can undermine patients’ engagement and compliance in the rehabilitation process. Therefore, enhancing self-awareness, for instance through metacognitive strategy training (Copley et al., 2020; Jaywant et al., 2020), should be a key focus in post-stroke cognitive rehabilitation (for a systematic review please see, Bampa et al., 2021).

However, some study limitations should be acknowledged. The first limitation is the small sample size, which may have led to an overestimation of the effect and prevented differentiation of the sample based on the side of the stroke. The second limitation is relying on a screening tool such as the Oxford Cognitive Screen instead of conducting a more comprehensive neuropsychological assessment. In addition, it should be noted that most control participants achieved the maximum score on the MPMT_event, resulting in a median of 3, which suggests a ceiling effect. Namely, only two healthy participants scored below the maximum. However, we carefully checked their test performance and behavioural data, and found no signs of disengagement or misunderstanding during the task. Therefore we have no specific reason to question the validity of their performance. Moreover, lesion characteristics, such as aetiology, hemisphere, and localization, can significantly influence cognitive outcomes. However, given the limited size of our clinical sample, conducting subgroup analyses would not have yielded statistically reliable results due to insufficient power. Therefore, this remains an important limitation of the present study, and future research with larger samples may further investigate this aspect. Finally, the difference between normal self-reported prospective memory on the PRMQ and performance on the MPMT in patients with stroke may represent a genuine finding or simply reflect a limitation of the assessment tool. In this vein, further research is advisable to develop measures that allow for meaningful comparison between subjective and objective prospective memory performance.

Funding

This publication was produced with the co-funding European Union - Next Generation EU, in the context of The National Recovery and Resilience Plan, Investment 1.5 Ecosystems of Innovation, Project Tuscany Health Ecosystem (THE), CUP: B83C22003920001.

Conflict of interest

None declared.

Author contributions

Virginia Ambrogi (Conceptualization, Data curation, Investigation, Methodology), Fabio Giovannelli (Conceptualization, Formal analysis, Writing - original draft, Writing - review & editing), Stefania Righi (Methodology, Writing - review & editing), Ilaria Pellegrini (Methodology), Sara Della Bella (Methodology), and Chiara Pedrini (Methodology)

References