Rufus O Akinyemi1, Louise Allan2, Mayowa O Owolabi3, Joshua O Akinyemi4, Godwin Ogbole5, Akinlolu Ajani6, Michael Firbank2, Adesola Ogunniyi3, Raj N Kalaria7. 1. Division of Neurology, Department of Medicine, Federal Medical Center Abeokuta, Nigeria; Institute for Ageing and Health, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom. 2. Institute for Ageing and Health, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom. 3. Department of Medicine, University College Hospital/College of Medicine, University of Ibadan, Ibadan, Nigeria. 4. Department of Epidemiology and Medical Statistics, University College Hospital/College of Medicine, University of Ibadan, Ibadan, Nigeria. 5. Department of Radiology, University College Hospital/College of Medicine, University of Ibadan, Ibadan, Nigeria. 6. Division of Neurology, Department of Medicine, Federal Medical Center Abeokuta, Nigeria. 7. Institute for Ageing and Health, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom. Electronic address: raj.kalaria@ncl.ac.uk.
Abstract
OBJECTIVE: Sub-Saharan Africa faces a potential epidemic of non-communicable diseases including stroke and dementia but little is known about the burden of stroke-related cognitive dysfunction. We assessed the baseline profile and factors associated with vascular cognitive impairment (VCI) in stroke survivors participating in the Cognitive Function After STroke (CogFAST) Nigeria Study. METHODS: We recruited 217 subjects (>45 years old) comprising 143 stroke survivors and 74 demographically matched stroke-free healthy controls. We obtained demographic, clinical and lifestyle information and assessed the cognitive status of the subjects at baseline three months after stroke. Standard neuropsychological tests included the Vascular Neuropsychological Battery, which assessed executive function/mental speed, memory, language, and visuospatial/visuoconstructive functioning. Cognitive impairment and dementia were defined based on the AHA/ASA VCI guidelines and the DSM IV criteria. RESULTS: Among the stroke survivors (mean ag e= 60.4+9.5 years, 43.4% female, mean number of years of education = 9.4+5.6 years, median modified Rankin score = 2), 57 (39.9%) had cognitive impairment no dementia while 12 (8.4%) were demented at baseline. Multivariate analysis revealed that older age [OR = 1.05 (1.00-1.09)], low education [OR = 5.09 (2.17-11.95)], pre-stroke cognitive decline [OR = 4.51 (1.20-16.88)] and medial temporal lobe atrophy [OR = 2.25 (1.16-4.35)] were independently associated with cognitive dysfunction whereas pre-stroke daily intake of fish [p = 0.022, OR = 0.39 (0.15-0.89)] was inversely associated. CONCLUSIONS: These results suggest a high frequency of early VCI in older Nigerian stroke survivors. Apart from aging, associated neurodegeneration and cognitive decline, educational level and pre-stroke diet particularly fish consumption were identified as modifiable factors. This emphasizes the vital role of education and healthy nutrition in building reserves to ameliorate cognitive dysfunction after stroke.
OBJECTIVE: Sub-Saharan Africa faces a potential epidemic of non-communicable diseases including stroke and dementia but little is known about the burden of stroke-related cognitive dysfunction. We assessed the baseline profile and factors associated with vascular cognitive impairment (VCI) in stroke survivors participating in the Cognitive Function After STroke (CogFAST) Nigeria Study. METHODS: We recruited 217 subjects (>45 years old) comprising 143 stroke survivors and 74 demographically matched stroke-free healthy controls. We obtained demographic, clinical and lifestyle information and assessed the cognitive status of the subjects at baseline three months after stroke. Standard neuropsychological tests included the Vascular Neuropsychological Battery, which assessed executive function/mental speed, memory, language, and visuospatial/visuoconstructive functioning. Cognitive impairment and dementia were defined based on the AHA/ASA VCI guidelines and the DSM IV criteria. RESULTS: Among the stroke survivors (mean ag e= 60.4+9.5 years, 43.4% female, mean number of years of education = 9.4+5.6 years, median modified Rankin score = 2), 57 (39.9%) had cognitive impairment no dementia while 12 (8.4%) were demented at baseline. Multivariate analysis revealed that older age [OR = 1.05 (1.00-1.09)], low education [OR = 5.09 (2.17-11.95)], pre-stroke cognitive decline [OR = 4.51 (1.20-16.88)] and medial temporal lobe atrophy [OR = 2.25 (1.16-4.35)] were independently associated with cognitive dysfunction whereas pre-stroke daily intake of fish [p = 0.022, OR = 0.39 (0.15-0.89)] was inversely associated. CONCLUSIONS: These results suggest a high frequency of early VCI in older Nigerian stroke survivors. Apart from aging, associated neurodegeneration and cognitive decline, educational level and pre-stroke diet particularly fish consumption were identified as modifiable factors. This emphasizes the vital role of education and healthy nutrition in building reserves to ameliorate cognitive dysfunction after stroke.
Authors: Fred Stephen Sarfo; John Akassi; Sheila Adamu; Vida Obese; Bruce Ovbiagele Journal: J Stroke Cerebrovasc Dis Date: 2017-06-23 Impact factor: 2.136
Authors: A Ojagbemi; M Owolabi; R Akinyemi; O Arulogun; J Akinyemi; O Akpa; F S Sarfo; E Uvere; R Saulson; S Hurst; B Ovbiagele Journal: Acta Neurol Scand Date: 2017-04-17 Impact factor: 3.209
Authors: Albert Akpalu; Fred Stephen Sarfo; Bruce Ovbiagele; Rufus Akinyemi; Mulugeta Gebregziabher; Reginald Obiako; Lukman Owolabi; Kwamena Sagoe; Carolyn Jenkins; Oyedunni Arulogun; Sheila Adamu; Lambert T Appiah; Martin A Adadey; Francis Agyekum; Joseph A Quansah; Yaw B Mensah; Abiodun M Adeoye; Arti Singh; Aridegbe O Tosin; Osimhiarherhuo Ohifemen; Abubabkar A Sani; Eric Tabi-Ajayi; Ibinaiye O Phillip; Suleiman Y Isah; Nasir A Tabari; Aliyu Mande; Atinuke M Agunloye; Godwin I Ogbole; Joshua O Akinyemi; Onoja M Akpa; Ruth Laryea; Sylvia Ezinne Melikam; Dorcas Adinku; Ezinne Uvere; Nina-Serena Burkett; Gregory F Adekunle; Salaam I Kehinde; Paschal C Azuh; Abdul H Dambatta; Naser A Ishaq; Donna Arnett; Hemant K Tiwari; Dan Lackland; Mayowa Owolabi Journal: Neuroepidemiology Date: 2015-08-19 Impact factor: 3.282
Authors: Fred Stephen Sarfo; Linda Meta Mobula; Titus Adade; Yvonne Commodore-Mensah; Martin Agyei; Collins Kokuro; Rexford Adu-Gyamfi; Christiana Duah; Bruce Ovbiagele Journal: J Neurol Sci Date: 2020-03-04 Impact factor: 3.181
Authors: R Akinyemi; H K Tiwari; D K Arnett; B Ovbiagele; M R Irvin; K Wahab; F Sarfo; V Srinivasasainagendra; A Adeoye; R T Perry; A Akpalu; C Jenkins; O Arulogun; M Gebregziabher; L Owolabi; R Obiako; E Sanya; M Komolafe; M Fawale; P Adebayo; G Osaigbovo; T Sunmonu; P Olowoyo; I Chukwuonye; Y Obiabo; A Onoja; J Akinyemi; G Ogbole; S Melikam; R Saulson; M Owolabi Journal: Acta Neurol Scand Date: 2017-10-03 Impact factor: 3.209