Department of Neurology, Faculty of Medicine, University of P.J. Šafárik and University Hospital of L. Pasteur, Trieda SNP 1, 04011 Košice, Slovakia.
Medicina (Kaunas). 2023 Mar 22;59(3):637. doi: 10.3390/medicina59030637.
Post-stroke cognitive impairment (PSCI) has been defined as all problems in cognitive function that occur following a stroke. Studies published thus far on the prevalence of PSCI and post-stroke dementia (PSD) have shown conflicting estimates. The aim of this study was screening for cognitive impairment (CogI) in patients with an ischaemic stroke and finding the relationship between CogI (and its changes) and cardiovascular risk factors and imaging procedures-CT/MRI. We prospectively included patients with an ischaemic stroke admitted in the period from October 2019 to May 2022. In this period, 1328 patients were admitted, 305 of whom met the established inclusion criteria and underwent an examination of cognitive functions using the Montreal Cognitive Assessment (MoCA). Of these, 50 patients appeared for the control examination after 6 months. In the retested group, CogI at discharge was diagnosed in 37 patients (74%). In follow-up testing after 6 months, CogI was present in 30 patients (60%). Only arterial hypertension (OR: 15; 95% CI; Pearson r: 0.001), lower education level (less than 13 years) (OR: 9.7; 95% CI 2.0-48.5; Pearson r: 0.002), and higher age were significantly associated with CogI after stroke. We established the prevalence of CogI and its course after 6 months in a well-defined group of patients after a mild ischaemic stroke (mean NIHSS: 2 and mean mRS: 1 at the discharge). Our results show that the prevalence of CogI after an ischaemic stroke at discharge is relatively high (74%), and it tends to be a spontaneous reduction. Cognitive functions were changed in 35% of patients. The definition of PSCI was completed in only 24% of individuals. Only an examination several months after a stroke can give us more accurate information about the true prevalence of persistent CogI after a stroke.
卒中后认知障碍（PSCI）被定义为卒中后出现的所有认知功能问题。迄今为止，关于 PSCI 和卒中后痴呆（PSD）的患病率的研究结果存在矛盾。本研究旨在筛查缺血性卒中患者的认知障碍（CogI），并发现 CogI（及其变化）与心血管危险因素和影像学检查（CT/MRI）之间的关系。我们前瞻性纳入 2019 年 10 月至 2022 年 5 月期间收治的缺血性卒中患者。在此期间，共收治了 1328 名患者，其中 305 名符合既定纳入标准，并使用蒙特利尔认知评估（MoCA）检查认知功能。其中，50 名患者在 6 个月后进行了对照检查。在重新测试组中，37 名患者（74%）在出院时被诊断为 CogI。在 6 个月后的随访测试中，30 名患者（60%）存在 CogI。只有动脉高血压（OR：15；95%CI；Pearson r：0.001）、较低的教育水平（小于 13 年）（OR：9.7；95%CI 2.0-48.5；Pearson r：0.002）和较高的年龄与卒中后 CogI 显著相关。我们在一组定义明确的轻度缺血性卒中（出院时 NIHSS 平均为 2，mRS 平均为 1）患者中确定了卒中后 6 个月 CogI 的患病率及其病程。我们的结果表明，缺血性卒中出院时 CogI 的患病率相对较高（74%），且有自发下降的趋势。35%的患者的认知功能发生了变化。只有 24%的个体完成了 PSCI 的定义。只有在卒中后几个月进行检查，才能为我们提供关于卒中后持续性 CogI 的真实患病率的更准确信息。
