Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.
Department of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands.
Int J Stroke. 2023 Oct;18(8):888-897. doi: 10.1177/17474930231159267. Epub 2023 Mar 7.
Information about cognitive functioning is vital in the management of stroke, but the literature is mostly based on data from individuals older than 50 years of age who make up the majority of the stroke population. As cognitive functioning is subject to change due to aging, it is unclear whether such cognitive impairment patterns from the general stroke literature apply to the growing population of younger people with a stroke.
The aim of the study was to conduct a systematic review and meta-analysis of the proportion and severity of cognitive impairment in young-stroke patients.
MEDLINE, Embase, PsycINFO, and Web of Science were systematically searched up to 11 October 2022. Studies were included if they reported on a population of young-stroke patients, evaluated cognitive functioning as an outcome measure, and reported original data. We estimated the pooled prevalence rates for cognitive impairment and for aphasia. In addition, we calculated the pooled estimates for the severity of impairment per cognitive domain in the chronic phase (defined as >6 months post-stroke). Six hundred thirty-five articles were identified, of which 29 were eligible for inclusion. The pooled prevalence of cognitive impairment was 44% ( = 10; 95% confidence interval (CI): 34-54%) and of aphasia 22% ( = 13; 95% CI: 12-39%). Young-stroke patients in the chronic phase performed worse than stroke-free healthy age-appropriate controls across all cognitive domains examined, with Hedges' g effect sizes ranging from -0.49 to -1.64.
Around half of all young-stroke patients present with cognitive impairment and around a quarter with aphasia. Our data suggest that patterns of impairment in young-stroke patients follow those in the general stroke literature.
在处理中风时，有关认知功能的信息至关重要，但文献大多基于年龄在 50 岁以上的个体的数据，而这些个体构成了中风人群的大多数。由于认知功能会随着年龄的增长而发生变化，因此尚不清楚一般中风文献中的这些认知障碍模式是否适用于越来越多的年轻中风患者。
本研究旨在对年轻中风患者的认知障碍比例和严重程度进行系统评价和荟萃分析。
系统检索了 MEDLINE、Embase、PsycINFO 和 Web of Science，截至 2022 年 10 月 11 日。如果研究报告了年轻中风患者人群，将认知功能作为结局指标进行评估，并报告原始数据，则纳入研究。我们估计了认知障碍和失语症的总体患病率。此外，我们还计算了慢性期（定义为中风后 >6 个月）每个认知域损伤严重程度的汇总估计值。共确定了 635 篇文章，其中 29 篇符合纳入标准。认知障碍的总体患病率为 44%（ = 10；95%置信区间[CI]：34-54%），失语症的总体患病率为 22%（ = 13；95% CI：12-39%）。在所有检查的认知领域中，慢性期的年轻中风患者的表现均不如无中风的年龄匹配健康对照组，Hedges'g 效应大小范围为-0.49 至-1.64。
大约一半的年轻中风患者存在认知障碍，大约四分之一的患者存在失语症。我们的数据表明，年轻中风患者的损害模式与一般中风文献中的模式相似。
