World Health Organization (WHO) Collaborating Centre for Research and Training in Mental health, Neuroscience, and Substance abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Department of Psychiatry, College of Medicine University of Ibadan, Ibadan, Nigeria.
J Geriatr Psychiatry Neurol. 2022 Jul;35(4):565-573. doi: 10.1177/08919887211036190. Epub 2021 Aug 2.
There is limited information on new onset poststroke dementia (NPSD) in sub-Saharan Africa (SSA). We estimated incidence, cumulative incidence, risk factors and outcome of NPSD at 1 year in Nigerian survivors of a first-ever stroke.
Hospital-based prospective observational study. Assessments for global cognition, learning, memory, executive and activities of daily life (ADL) functioning were conducted at 3 poststroke timepoints (Baseline, 3- and 12 months). NPSD was ascertained according to the "National Institute of Neurological Disorders and Stroke and the Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS-AIREN) criteria." Outcomes were assessed using the modified Rankin Scale (mRS), center for epidemiologic studies depression scale (CES-D 10), health related quality of life in stroke patients (HRQOLISP-26) and caregivers strain index (CSI).
Among 144 stroke survivors who were free of dementia at baseline, we found a 1-year cumulative incidence of 4.52% (95% C.I = 3.20, 6.39). In multivariate Cox regression analyses, diabetes was associated with NPSD (Hazard Ratio = 2.10, 95% CI = 1.02, 4.35). NPSD at 3 months was independently associated with motor decline [Mean difference (MD) in mRS = 1.6, 95% C.I = 0.9, 2.3)], depression (MD in CES-D = 2.9, 95% C.I = 0.3, 5.4), caregivers burden (MD in CSI = 1.2, 95% C.I = 0.5, 1.8), and poor quality of life (MD in HRQOLISP-26 = -11.2, 95% C.I = -15.7, -6.8) at 1 year.
Approximately 4.5% of stroke survivors in Nigeria had NPSD at 1 year. Diabetes, which can be prevented, represent a primary prevention target for NPSD and its consequences in SSA.
在撒哈拉以南非洲（SSA），关于新发卒中后痴呆（NPSD）的信息有限。我们估计了尼日利亚首次卒中幸存者在 1 年内 NPSD 的发病率、累积发病率、危险因素和结局。
这是一项基于医院的前瞻性观察性研究。在 3 个卒中后时间点（基线、3 个月和 12 个月）对整体认知、学习、记忆、执行和日常生活活动（ADL）功能进行评估。根据“美国国立卫生研究院神经紊乱和卒中研究所和国际神经病学研究与教育促进协会（NINDS-AIREN）标准”确定 NPSD。使用改良 Rankin 量表（mRS）、流行病学研究抑郁量表（CES-D 10）、卒中患者健康相关生活质量量表（HRQOLISP-26）和照顾者负担指数（CSI）评估结局。
在 144 名基线时无痴呆的卒中幸存者中，我们发现 1 年累积发病率为 4.52%（95%置信区间为 3.20，6.39）。多变量 Cox 回归分析显示，糖尿病与 NPSD 相关（风险比=2.10，95%置信区间为 1.02，4.35）。3 个月时的 NPSD 与运动能力下降独立相关（mRS 差值=1.6，95%置信区间为 0.9，2.3）、抑郁（CES-D 差值=2.9，95%置信区间为 0.3，5.4）、照顾者负担（CSI 差值=1.2，95%置信区间为 0.5，1.8）和生活质量差（HRQOLISP-26 差值=-11.2，95%置信区间为-15.7，-6.8），均在 1 年内。
在尼日利亚，约有 4.5%的卒中幸存者在 1 年内发生 NPSD。糖尿病是可以预防的，代表了 SSA 中 NPSD 及其后果的一级预防目标。
