Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Ren'ai Road, Suzhou, 215123, China.
Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
BMC Med. 2023 Jun 6;21(1):204. doi: 10.1186/s12916-023-02908-5.
While cognitive impairment after stroke is common, cognitive trends before stroke are poorly understood, especially among the Chinese population who have a relatively high stroke burden. We aimed to model the trajectories of cognitive function before and after new-onset stroke among Chinese.
A total of 13,311 Chinese participants aged ≥ 45 years and without a history of stroke were assessed at baseline between June 2011 and March 2012 and in at least one cognitive test between 2013 (wave 2) and 2018 (wave 4). Cognitive function was assessed using a global cognition score, which included episodic memory, visuospatial abilities, and a 10-item Telephone Interview of Cognitive Status (TICS-10) test to reflect calculation, attention, and orientation abilities.
During the 7-year follow-up, 610 (4.6%) participants experienced a first stroke. Both stroke and non-stroke groups showed declined cognitive function during follow-up. After adjustment for covariates, there was no significant difference in pre-stroke cognitive trajectories between stroke patients and stroke-free participants. The stroke group showed an acute decline in episodic memory (- 0.123 SD), visuospatial abilities (- 0.169 SD), and global cognition (- 0.135 SD) after stroke onset. In the years following stroke, the decline rate of the TICS-10 test was higher than the rate before stroke (- 0.045 SD/year).
Chinese stroke patients had not experienced steeper declines in cognition before stroke compared with stroke-free individuals. Incident stroke was associated with acute declines in global cognition, episodic memory, visuospatial abilities, and accelerated declines in calculation, attention, and orientation abilities.
尽管卒中后认知障碍较为常见，但卒中前认知趋势仍知之甚少，尤其是在中国人群中，卒中负担相对较高。我们旨在建立中国人群新发卒中前后认知功能的轨迹模型。
共有 13311 名年龄≥45 岁且无卒中病史的中国参与者于 2011 年 6 月至 2012 年 3 月基线期接受评估，并于 2013 年（第 2 波）至 2018 年（第 4 波）至少进行了一次认知测试。认知功能采用总体认知评分评估，包括情景记忆、视空间能力和包含计算、注意力和定向能力的 10 项电话认知状态测试（TICS-10）。
在 7 年的随访期间，610（4.6%）名参与者发生了首次卒中。卒中组和非卒中组在随访期间认知功能均下降。调整协变量后，卒中患者与无卒中参与者之间的卒中前认知轨迹无显著差异。卒中后，卒中组情景记忆（-0.123 SD）、视空间能力（-0.169 SD）和总体认知（-0.135 SD）均出现急性下降。在卒中后几年中，TICS-10 测试的下降速度高于卒中前（-0.045 SD/年）。
与无卒中个体相比，中国卒中患者在卒中前认知功能下降速度并不更快。新发卒中与总体认知、情景记忆、视空间能力的急性下降以及计算、注意力和定向能力下降速度加快有关。
