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, Nigeria; Department of Psychiatry, College of Medicine University of Ibadan, Nigeria.
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, Nigeria.
J Neurol Sci. 2021 Oct 15;429:117619. doi: 10.1016/j.jns.2021.117619. Epub 2021 Aug 19.
Pre-existing cognitive decline is a risk factor for stroke onset and poststroke dementia. There is a knowledge gap on prestroke cognitive decline in indigenous Africans. We estimated prevalence and predictors of prestroke cognitive decline, as well as its association with poststroke dementia at one year in Nigerian survivors of a first ever stroke.
Prospective observational study. Prestroke cognitive decline was ascertained using an average score > 3.31 on the 16-item Informant Questionnaire for Cognitive Decline in the Elderly (IQ-CODE). Poststroke dementia 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'. Associations were investigated using multivariate logistic regression models and presented as odds ratios (O.R) within 95% confidence intervals (C.I).
Among 150 stroke survivors, prestroke cognitive decline was found in 25 (16.7%, 95% C.I = 11.5%-23.6%). In analyses adjusting for the effect of age, education and stroke severity, prestroke cognitive decline was associated with diabetes mellitus (O.R = 3.0, 95% C.I = 1.2-7.6). Ten (62.5%) survivors in the prestroke cognitive decline sub-sample developed dementia at one-year poststroke. In analyses adjusting for the effects of age, education, stroke severity and comorbid diabetes mellitus, survivors with prestroke cognitive decline had six times the odds of dementia at one year poststroke (O.R = 6.2, 95% C.I = 1.3-30.4).
Prestroke cognitive decline is common, assessment is feasible and identifying pre-stroke problems has prognostic implications.
认知衰退是中风发病和中风后痴呆的危险因素。在非洲原住民中，关于中风前认知衰退的知识存在差距。我们评估了尼日利亚首次中风幸存者的中风前认知衰退的患病率和预测因素，以及其与一年后中风后痴呆的关系。
前瞻性观察研究。使用 16 项认知衰退老年患者知情者问卷（IQ-CODE）的平均得分为> 3.31 来确定中风前认知衰退。根据“国家神经疾病和中风研究所和国际神经病学研究与教育协会（NINDS-AIREN）标准”确定中风后痴呆。使用多元逻辑回归模型研究相关性，并以 95%置信区间（CI）内的优势比（O.R）表示。
在 150 名中风幸存者中，发现 25 名（16.7%，95%CI=11.5%-23.6%）存在中风前认知衰退。在调整年龄、教育和中风严重程度影响的分析中，中风前认知衰退与糖尿病相关（O.R=3.0，95%CI=1.2-7.6）。在中风前认知衰退亚组中，有 10 名（62.5%）幸存者在一年后发展为痴呆。在调整年龄、教育、中风严重程度和合并糖尿病影响的分析中，中风前认知衰退的幸存者在一年后发生痴呆的可能性是普通幸存者的六倍（O.R=6.2，95%CI=1.3-30.4）。
中风前认知衰退很常见，评估是可行的，识别中风前的问题具有预后意义。
