BACKGROUND: The long-term (>12 months) prevalence, predictors, and trajectory of post-stroke cognitive deficits are not well established, especially at a community level. This study investigated the longitudinal course and prevalence of cognitive impairment in an incidence cohort, identifying factors associated with declining cognition. METHODS: Two hundred fifty-seven participants (mean age = 67.93 ± 13.59) of first-ever stroke survivors, completed cognitive assessments within 2 weeks post stroke, and/or 1, 6, 12, and 48-month. Multivariate linear and logistic models were used to identify baseline predictors (reported as OR with 95% CI) and trajectory of cognitive impairment. RESULTS: Cognitive functioning significantly declined by 2.8 points by 4 years post stroke. Eighty-four percent of stroke survivors had cognitive impairment indicative of post-stroke dementia (mean Montreal cognitive assessment = 20 ± 4.7) at 4-year. There were significant as-sociations between progressive cognitive decline and the -following factors: male gender (OR 2.9, 95% CI 1.6-5.9, -p = 0.0171), coronary artery disease (OR 2.96, 95% CI 1.35-6.49, p = 0.0070), arrhythmia (OR 2.21, 95% CI 1.07-4.57, p = 0.0317), not in a relationship (OR 2.8, 95% CI 1.4-5.50, p < 0.0001), and not employed (OR 4.9, 95% CI 1.9-12.1, p < 0.0001). CONCLUSIONS: Cognitive deficits remain highly prevalent at 4-year post stroke. Early identification of those at higher risk of declining cognition is vital to target rehabilitation interventions at the acute stage and improve overall outcomes.
BACKGROUND: The long-term (>12 months) prevalence, predictors, and trajectory of post-stroke cognitive deficits are not well established, especially at a community level. This study investigated the longitudinal course and prevalence of cognitive impairment in an incidence cohort, identifying factors associated with declining cognition. METHODS: Two hundred fifty-seven participants (mean age = 67.93 ± 13.59) of first-ever stroke survivors, completed cognitive assessments within 2 weeks post stroke, and/or 1, 6, 12, and 48-month. Multivariate linear and logistic models were used to identify baseline predictors (reported as OR with 95% CI) and trajectory of cognitive impairment. RESULTS: Cognitive functioning significantly declined by 2.8 points by 4 years post stroke. Eighty-four percent of stroke survivors had cognitive impairment indicative of post-stroke dementia (mean Montreal cognitive assessment = 20 ± 4.7) at 4-year. There were significant as-sociations between progressive cognitive decline and the -following factors: male gender (OR 2.9, 95% CI 1.6-5.9, -p = 0.0171), coronary artery disease (OR 2.96, 95% CI 1.35-6.49, p = 0.0070), arrhythmia (OR 2.21, 95% CI 1.07-4.57, p = 0.0317), not in a relationship (OR 2.8, 95% CI 1.4-5.50, p < 0.0001), and not employed (OR 4.9, 95% CI 1.9-12.1, p < 0.0001). CONCLUSIONS:Cognitive deficits remain highly prevalent at 4-year post stroke. Early identification of those at higher risk of declining cognition is vital to target rehabilitation interventions at the acute stage and improve overall outcomes.
Authors: David Rosenbaum Halevi; Andrew W Bursaw; Rahul R Karamchandani; Susan E Alderman; Joshua I Breier; Farhaan S Vahidy; James K Aden; Chunyan Cai; Xu Zhang; Sean I Savitz Journal: Ann Clin Transl Neurol Date: 2019-01-22 Impact factor: 4.511
Authors: Daniela Rohde; Eva Gaynor; Margaret Large; Lisa Mellon; Kathleen Bennett; David J Williams; Linda Brewer; Patricia Hall; Elizabeth Callaly; Eamon Dolan; Anne Hickey Journal: PLoS One Date: 2019-10-17 Impact factor: 3.240
Authors: Knut K Kolskår; Geneviève Richard; Dag Alnaes; Erlend S Dørum; Anne-Marthe Sanders; Kristine M Ulrichsen; Jennifer Monereo Sánchez; Hege Ihle-Hansen; Jan E Nordvik; Lars T Westlye Journal: Hum Brain Mapp Date: 2020-11-20 Impact factor: 5.399