Association between mild vascular cognitive impairment and impaired activities of daily living in older stroke survivors without dementia.

OBJECTIVES

To determine the relationship between mild vascular cognitive impairment (mVCI) and functional disability in older stroke survivors without dementia.

DESIGN

Cohort study.

SETTING

Stroke patients from representative hospital-based stroke registers.

PARTICIPANTS

Three hundred thirty-nine stroke survivors without dementia, aged 75 and older.

MEASUREMENTS

Neuropsychological assessments were completed 3 months poststroke. Activities of daily living (ADLs) were evaluated using the Bristol scale. Operationalized criteria, including cognitive impairment no dementia (CIND), were applied for mVCI.

RESULTS

Significant impairments of ADLs were evident in mVCI (CIND vs no CIND; basic care: z=3.2; P=.001, intermediate care: z=3.6; P<.001, complex management: z=4.5; P<.001) but varied according to the profile of cognitive impairments. Patients with attentional or global impairments had more severe functional disability than patients with isolated memory deficits, with an intermediate level of dysfunction in patients with executive impairments.

CONCLUSION

The findings emphasize the importance of identifying early cognitive impairments to optimize rehabilitation, care planning, and secondary prevention of dementia in stroke patients.