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中风后三个月的痴呆和认知障碍

Dementia and cognitive impairment three months after stroke.

作者信息

Madureira S, Guerreiro M, Ferro J M

机构信息

Stroke Unit, Neurology Department, Hospital de Santa Maria, Lisboa, Portugal.

出版信息

Eur J Neurol. 2001 Nov;8(6):621-7. doi: 10.1046/j.1468-1331.2001.00332.x.

Abstract

To investigate the cognitive capacities of a cohort of ischaemic or haemorrhagic stroke survivors and to identify the clinical determinants of post-stroke cognitive impairment, we evaluated 237 patients admitted to a Stroke Unit (mean age 59; SD=12.7). Three months after stroke, patients were submitted to a neuropsychological evaluation that included the Mini-Mental State Examination (MMSE), a complementary battery to assess specific cognitive domains, the Hamilton Depression Rating Scale (HDRS) and the Blessed Dementia Scale (BDS). Disturbed performance on at least one domain was detected on 131 (55%) patients: 27% had cognitive deficits other than memory, 7% had focal memory deficit, 9% had memory and other cognitive deficits and 6% had dementia. Dementia was associated with female gender (P=0.01), older age (P=0.01) and lower education level (P=0.04). Patients with memory deficits were older (P=0.01) with lower educational level (P=0.08) and more left sided lesions (P=0.02) than patients without memory deficits. In this middle aged stroke survivors cognitive impairment was common 3 months after stroke, while dementia was infrequent.

摘要

为研究一组缺血性或出血性中风幸存者的认知能力,并确定中风后认知障碍的临床决定因素,我们评估了237名入住卒中单元的患者(平均年龄59岁;标准差=12.7)。中风后三个月,患者接受了神经心理学评估,包括简易精神状态检查表(MMSE)、一套用于评估特定认知领域的补充测试、汉密尔顿抑郁量表(HDRS)和布列斯痴呆量表(BDS)。131名(55%)患者至少在一个领域的表现存在异常:27%有除记忆之外的认知缺陷,7%有局灶性记忆缺陷,9%有记忆及其他认知缺陷,6%患有痴呆。痴呆与女性性别(P=0.01)、年龄较大(P=0.01)和教育水平较低(P=0.04)相关。与无记忆缺陷的患者相比,有记忆缺陷的患者年龄较大(P=0.01)、教育水平较低(P=0.08)且左侧病变较多(P=0.02)。在这组中年中风幸存者中,中风后三个月认知障碍很常见,而痴呆并不常见。

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