Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Santiago, Chile. cdelgado @ med.uchile.cl
Dement Geriatr Cogn Disord. 2010;29(5):397-405. doi: 10.1159/000305097. Epub 2010 May 19.
A higher risk of poststroke cognitive impairment (CI) has been reported in Hispanics in a US cohort but has not been systematically studied in Latin America.
Our purpose was to investigate the frequencies and determinants of poststroke CI in the hispano-mestizo population of Santiago, Chile.
A prospective study of hospitalized patients aged >60 years admitted with an ischemic or hemorrhagic stroke was conducted. The cognitive status was determined at 3 and 12 months after the stroke by informant questionnaires, neuropsychological testing and clinical diagnosis. Cardiovascular risk factors, brain imaging and stroke features were analyzed using regression models to establish determinants for poststroke CI.
A total of 164 patients (mean age = 72 +/- 7.5 years) were recruited. Out of 122 patients (74%) evaluated at 3 months, 81 (66%) had CI. Out of 101 patients (62%) evaluated at 12 months, 39 (39%) had CI no dementia, and 22 (22%) were demented. The new-onset dementia frequency at 1 year was 16%. Independent determinants for dementia were higher functional impairment at hospital egress (OR = 4.0), left-hemisphere large-vessel infarction (OR = 6.9) and a larger amount of white matter changes (OR = 1.3).
In this first study on poststroke CI in Latin America, the frequencies and determinants of poststroke CI were similar to those in other cohorts of different ethnic origin.
在美国的队列研究中，西班牙裔人群发生卒中后认知障碍（CI）的风险较高，但在拉丁美洲尚未对此进行系统研究。
我们旨在调查智利圣地亚哥的西班牙裔混血人群中卒中后 CI 的发生频率及其决定因素。
对因缺血性或出血性卒中住院的>60 岁患者进行前瞻性研究。通过知情者问卷、神经心理学测试和临床诊断，在卒中后 3 个月和 12 个月评估认知状态。采用回归模型分析心血管危险因素、脑影像学和卒中特征，以确定卒中后 CI 的决定因素。
共纳入 164 例患者（平均年龄 72 +/- 7.5 岁）。122 例患者（74%）在 3 个月时接受评估，其中 81 例（66%）有 CI。101 例患者（62%）在 12 个月时接受评估，其中 39 例（39%）无痴呆，22 例（22%）为痴呆。1 年后新发痴呆的频率为 16%。痴呆的独立决定因素是出院时功能障碍程度较高（OR = 4.0）、左侧大脑中动脉大血管梗死（OR = 6.9）和更多的脑白质改变（OR = 1.3）。
在拉丁美洲关于卒中后 CI 的首次研究中，卒中后 CI 的发生频率及其决定因素与其他不同种族来源的队列相似。
