Department of Medicine, Universiti Kebangsaan Medical Centre, Kuala Lumpur, Malaysia.
Department of Paediatrics, Universiti Kebangsaan Medical Centre, Kuala Lumpur, Malaysia.
Front Public Health. 2020 Nov 12;8:577940. doi: 10.3389/fpubh.2020.577940. eCollection 2020.
Stroke is highly prevalent globally and is an important cause of cognitive impairment and dementia. We determined the frequency of post-stroke cognitive impairment (PSCI) at 1, 3, and 6 months among patients with first clinical ischemic stroke compared to risk and age-matched controls. This study involved 32 cases and 32 controls, and was conducted over 6 months. Cases were inpatients aged >60 with first clinical ischemic stroke. Controls were age-matched subjects without prior stroke. Montreal Cognitive Assessment (MoCA) was performed in all patients at 1, 3, and 6 month post stroke. A MoCA score of <26 was used for mild PSCI and <22 for moderate PSCI (post stroke dementia). Post-stroke dementia was detected in 12 patients (37.5%) at 1 month, in 13 (40.6%) at 3 month and 15 (48.4%) at 6 months. Mild PSCI was present in 7 patients (21.6%) at 1 month, 16 patients (50%) at 3 months, and 15 patients (48%) at 6 months. The odds ratio (OR) for post-stroke dementia was 3.2 (95%CI 0.98-10.68; = 0.05) at 1 month; 3.69(95% CI 1.13-12.11; = 0.031) at 3 months, and 4.88 (95% CI 1.49-15.99; = 0.009) at 6 months. Years of education was an independent predictor for dementia (OR 0.60; = 0.046). The OR for post-stroke dementia at 6 month was 7.23 with education level adjusted (95%CI 1.46-35.86, = 0.015). The frequency of PSCI was high as early as 1 month after stroke. Stroke alone conferred a 7.2 times risk for post-stroke dementia compared to controls.
中风在全球高发，是认知障碍和痴呆的重要病因。我们旨在比较初发临床缺血性卒中患者与风险和年龄匹配对照者在卒中后 1、3、6 个月时的认知障碍（PSCI）发生率。本研究纳入 32 例病例和 32 例对照者，历时 6 个月。病例为年龄＞60 岁、初次发生临床缺血性卒中的住院患者。对照者为无既往卒中史、年龄匹配的患者。所有患者在卒中后 1、3、6 个月时均接受蒙特利尔认知评估（MoCA）。MoCA 评分＜26 分提示轻度 PSCI，＜22 分提示中度 PSCI（卒中后痴呆）。1 个月时，12 例（37.5%）患者被诊断为卒中后痴呆，3 个月时为 13 例（40.6%），6 个月时为 15 例（48.4%）。1 个月时，7 例（21.6%）患者存在轻度 PSCI，3 个月时为 16 例（50%），6 个月时为 15 例（48%）。1 个月时卒中后痴呆的优势比（OR）为 3.2（95%CI 0.98-10.68； = 0.05），3 个月时为 3.69（95%CI 1.13-12.11； = 0.031），6 个月时为 4.88（95%CI 1.49-15.99； = 0.009）。受教育年限是痴呆的独立预测因素（OR 0.60； = 0.046）。校正教育程度后，6 个月时卒中后痴呆的 OR 为 7.23（95%CI 1.46-35.86， = 0.015）。卒中后 1 个月时 PSCI 发生率即较高。与对照者相比，卒中本身使卒中后痴呆的风险增加 7.2 倍。
