# Weekend sedentary behaviour and cognition three months after stroke based on the exploratory analysis of the CANVAS study

## TL;DR

This study explores how weekend sedentary behavior affects cognitive performance in stroke survivors three months after their stroke.

## Contribution

The study is the first to explore weekday-weekend differences in sedentary behavior and their link to cognition after stroke.

## Key findings

- Stroke survivors are more sedentary on weekends compared to weekdays, unlike controls.
- Higher weekend sedentary behavior is associated with worse cognitive performance, especially memory.
- Reducing weekend sedentary time may help preserve cognition after stroke.

## Abstract

Stroke survivors experience high levels of sedentary behaviour. However, less is known about the variability in weekday-weekend patterns of sedentary behaviour and whether it is linked to cognitive performance. We examined whether there was a difference in weekend and weekday amount of time spent in sedentary and moderate-to-vigorous physical activity (MVPA) at three months post-stroke and whether there was an association between these patterns and cognitive performance at three months. We included ischaemic stroke survivors from the Cognition And Neocortical Volume After Stroke (CANVAS) cohort, with objective physical activity data estimated using the SenseWear® Armband. We compared physical activity levels between 97 stroke survivors (minor severity) and 37 control participants on weekends and weekdays in sedentary and MVPA zones. We then linked these outcomes to cognitive functioning at three months. While both stroke and control groups had a comparable decrease in MVPA on weekends compared to weekdays, we observed a significant increase in sedentary activity [55 min on average (95% Confidence Interval 77 − 33) with a small effect size - partial eta squared = 0.036)] on weekends in the stroke group but not in controls. When we compared two groups of stroke participants ‘more sedentary’ vs. ‘less sedentary’—based on weekend activity, we observed a higher proportion of stroke survivors classified as cognitively impaired vs. cognitively normal in the ‘more sedentary’ group. Further analysis showed the groups differed significantly on their cognitive performance, especially in the memory domain. There is a significant difference in the amount of sedentary behaviour, but not MVPA, on weekends vs. weekdays in the stroke group. Furthermore, we demonstrate that a higher amount of sedentary activity on the weekend is associated with worse cognitive performance at three months, especially on memory tasks. These results are exploratory but suggest that decreasing sedentary behaviour, especially on the weekend, could be specifically investigated as a therapeutic target to maintain better cognition after stroke.

The online version contains supplementary material available at 10.1038/s41598-025-93149-4.