Objective:To investigate the relationship between cognitive impairments and rated activity restrictions.Design:Comparison of neuropsychological tests and activity questionnaires. Activity ratings were made by staff and stroke patients.Setting:Two neurological rehabilitation hospitals.Participants:Eighty-seven stroke patients.Results:Moderately high correlations were found between cognitive test scores and activity ratings made by staff members. In contrast, correlations between ratings made by patients and cognitive tests were much lower. There was also little agreement between the staffs' ratings and the patients' own ratings. Multiple regression analyses indicate that cognitive impairments account for 28.9% of the variance in the activity rating made by the staff members. The coefficient of determination was slightly higher when age, time since onset of illness, and depression scores were included as predictors.Conclusions:These findings provide partial support for a hierarchical structure of the “International Classification of Impairment, Activities and Participation” model of the World Health Organization.