Persisting cognitive impairment predicts functional dependence at 1 year after stroke and transient ischemic attack: a longitudinal, cohort study

BMC Geriatrics

Research

Yanhong Dong¹  Lijun Zuo²  Yilong Wang²  Jiong Shi²  Xiaoling Liao²  Xingquan Zhao²  Yongjun Wang³  Hongyi Yan⁴  Hao Li⁴  Xia Meng⁴  Yuesong Pan⁴ 

[1] Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Clinical Research Centre, Block MD11, Level 2, 10 Medical Dr., 117597, Singapore, Singapore;Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South Fourth Ring West Road, Fengtai District, 100070, Beijing, China;Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South Fourth Ring West Road, Fengtai District, 100070, Beijing, China;National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China;National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China;

关键词: Mild stroke;    Persisting cognitive impairment;    Montreal cognitive assessment-Beijing;    Functional dependence;   

DOI  :  10.1186/s12877-022-03609-z

 received in 2022-07-10, accepted in 2022-11-11,  发布年份 2022

来源: Springer

【 摘 要 】

ObjectiveMinor stroke or transient ischemic attack (TIA) usually have mild and nondisabling symptoms, and these functional deficits may recover fully e.g., TIA, however, part of them still suffer from cognitive impairment and poor outcomes. We conducted a study to determine the relationship between cognition evaluated by Montreal Cognitive Assessment (MoCA) and poor functional outcomes assessed by the Modified Rankin Scale (mRS) (mRS ≥ 2) and Stroke Impact Scale (SIS)-16(SIS-16<25%).MethodsThe data of this study come from the impairment of cognition and Sleep (ICONS) after acute ischemic stroke or transient ischemic attack in Chinese patients study. A total of 1675 minor stroke patients and TIA patients were finally recruited. Patients’ cognition were evaluated by Montreal Cognitive Assessment (MoCA) scale at 2-week (2w), 3 months (3 m) and 1 year(1y). Cognitive impairment (CI) was defined as MoCA score ≤ 22. According to MoCA score, patients were divided into 4 groups: no PSCI group: with MoCA-2w>22 and MoCA-3 m>22; improved PSCI group: with MoCA-2w ≤ 2 and MoCA-3 m>22;delayed PSCI group: MoCA-2w>22 and MoCA-3 m ≤ 22; persisting PSCI group: with MoCA-2w ≤ 22 and MoCA-3 m ≤ 22.ResultsA total of 1675 stroke patients were recruited in this study. There were 818 patients (48.84%) who had PSCI at baseline. Of these, 123 patients (15%) had mRS ≥2 at 3 months. The persisting PSCI group was a significant predictor of functional dependence at 3 months and 1 year after stroke and when adjusted for covariates such as gender, age, history of stroke, depression and intracranial atherosclerotic stenosis, stroke subtype and acute infarction type.ConclusionPersisting PSCI increased the risk of poor functional outcome after 3 months and 1 year follow-up. These high-risk individuals should be identified for targeted rehabilitation and counseling to improve longer-term post-stroke outcome.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

12888_2022_4365_Article_IEq36.gif

12888_2022_4365_Article_IEq34.gif

12888_2022_4365_Article_IEq32.gif

12888_2022_4365_Article_IEq16.gif

12982_2022_119_Article_IEq233.gif