Affiliations: [a] Memory Centre, Department of Neurology, University Hospital, University of Burgundy, Stroke Registry, Dijon, France | [b] Clinical Investigation Center, Clinical Epidemiology/Clinical Trials, University Hospital, Dijon, France
Correspondence:
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Correspondence to: Agnès Jacquin, Memory Centre, Department of Neurology, University Hospital, Stroke Registry, 3 Rue du Faubourg Raines, 21000 Dijon, France. Tel.: +33 3 80 29 37 53; Fax: +33 3 80 29 36 72; E-mail: agnesjacquin@free.fr.
Abstract: Background:Because of the aging population and a rise in the number of stroke survivors, the prevalence of post-stroke cognitive impairment (PSCI) is increasing. Objective:To identify the factors associated with 3-month PSCI. Methods:All consecutive stroke patients without pre-stroke dementia, mild cognitive disorders, or severe aphasia hospitalized in the Neurology Department of Dijon, University Hospital, France (November 2010 – February 2012) were included in this prospective cohort study. Demographics, vascular risk factors, and stroke data were collected. A first cognitive evaluation was performed during the hospitalization using the Mini-Mental State Exam (MMSE) and the Montreal Cognitive Assessment (MOCA). Patients assessable at 3 months were categorized as cognitively impaired if the MMSE score was ≤26/30 and MOCA <26/30 or if the neuropsychological battery confirmed PSCI when the MMSE and MOCA were discordant. Multivariable logistic models were used to determine factors associated with 3-month PSCI. Results:Among the 280 patients included, 220 were assessable at 3 months. The overall frequency of 3-month PSCI was 47.3%, whereas that of dementia was 7.7%. In multivariable analyses, 3-month PSCI was associated with age, low education level, a history of diabetes mellitus, acute confusion, silent infarcts, and functional handicap at discharge. MMSE and MOCA scores during hospitalization were associated with 3-month PSCI (OR = 0.63; 95% CI: 0.54–0.74; p < 0.0001 and OR = 0.67; 95% CI: 0.59–0.76; p < 0.0001, respectively). Conclusion:Our study underlines the high frequency of PSCI in a cohort of mild stroke. The early cognitive diagnosis of stroke patients could be useful by helping physicians to identify those at a high risk of developing PSCI.
Keywords: Cognitive impairment, early cognitive assessment, prevalence, stroke
