Cognitive function in stroke survivors: A 10-year follow-up study

Delavaran, Hossein; Jönsson, Ann-Cathrine; Lövkvist, Håkan; Iwarsson, Susanne; Elmståhl, Sölve; Norrving, Bo; Lindgren, Arne

doi:10.1111/ane.12709

Cited by 100 publications

(69 citation statements)

References 39 publications

(107 reference statements)

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“…The MoCA has been frequently used in studies which explored the evolution of post-stroke cognitive impairment. Recently, Delavaran et al (2016) have reported that 61% of stroke patients with a median NIHSS at baseline of 3 had cognitive impairment 10-year post-stroke. They suggested that the MoCA was more accurate in the detection of long-term post-stroke cognitive impairment as compared to other scales such as the Mini-Mental State Evaluation.…”

Section: Discussionmentioning

confidence: 99%

Gait Change Is Associated with Cognitive Outcome after an Acute Ischemic Stroke

Sagnier

Renou

Olindo

et al. 2017

Front. Aging Neurosci.

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Background: Cognition and gait have often been studied separately after stroke whereas it has been suggested that these two domains could interact through a cognitive-motor interference.Objective: To evaluate the influence of gait changes on cognitive outcome after an ischemic stroke (IS).Methods: We conducted a prospective and monocentric study including patients admitted for an acute supratentorial IS with a National Institute of Health Stroke Score ≤ 15. Cognition, gait and motor disability were evaluated at baseline, 3 months and 1 year post-stroke, using the Montreal Cognitive Assessment (MoCA), the 10-m walking test (10-MWT) and the Fugl-Meyer motor assessment (FMMA). The effect of changes in 10-MWT over the year of follow-up on MoCA changes was estimated using a generalized linear mixed model with FMMA, age and gender as covariates.Results: Two hundred and Twelve patients were included (71% male, age 64 ± 13 years old). 10-MWT improved from baseline to 1 year (p < 0.001), as did MoCA (p < 0.001) and FMMA (p < 0.001) scores. Ninety-nine patients (47%) had a MoCA <26 at 1 year. Changes in 10-MWT were independently associated with changes in MoCA (β = −0.2, 95% CI −0.24 to −0.07, Bonferroni-corrected p-value = 0.002). Analyses of MoCA sub-scores suggested that changes in gait performance was associated with changes in executive functions and recall.Conclusion: Gait performance is associated with cognitive outcome after a mild to moderate IS, suggesting that they should be managed together to improve post-stroke independence.

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Section: Discussionmentioning

confidence: 99%

Gait Change Is Associated with Cognitive Outcome after an Acute Ischemic Stroke

Sagnier

Renou

Olindo

et al. 2017

Front. Aging Neurosci.

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“…The LSR has been previously described in detail [10, 15]. To detect first-ever stroke patients, research nurses in the LSR perform “hot pursuit” of stroke cases through daily weekday screenings of patient lists from the Emergency Department as well as in- and outpatient lists at the Department of Neurology at SUS Lund.…”

Section: Methodsmentioning

confidence: 99%

Temporal Trends of Stroke Epidemiology in Southern Sweden: A Population-Based Study on Stroke Incidence and Early Case-Fatality

et al. 2018

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Background: Up-to-date epidemiological stroke studies are important for healthcare planning and evaluating prevention strategies. This population-based study investigates temporal trends in stroke incidence and case-fatality in southern Sweden. Methods: First-ever stroke cases in the local catchment area of Skåne University Hospital in Lund, Sweden, between March, 2015 and February, 2016, were included from several sources, including 2 prospective hospital-based registers, retrospective screening of primary care visits, and autopsy registers. Stroke incidence and 28-day case-fatality rates were compared with data from this area obtained through similar methodology between March, 2001 and February, 2002. Results: Altogether, 456 and 413 first-ever stroke patients were identified during the earlier and later time periods respectively. The age- and sex-standardized stroke incidence rates decreased from 246 (95% CI 224–270) to 165 (95% CI 149–182) per 100,000 people. However, incidence remained unaltered among those <65 years. Early case-fatality decreased from 14 to 11% (p = 0.165). Conclusion: First-ever stroke incidence in southern Sweden has decreased with 33% since the beginning of this millennium. Incidence rates have decreased among the elderly but remain unchanged among younger age groups. Our findings warrant further studies on trends in risk factor profiles and effects of prevention strategies, and heightened focus on stroke in the young.

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“…Both MMSE and MoCA have been translated into Chinese and validated as a screening tool for cognitive impairment and dementia in the Chinese population; the maximum score is 30 for these 2 measurements. According to the recommended cutoffs, cognitive function was categorized as follows: 0 to 22 (severe cognitive impairment), 23 to 26 (mild cognitive impairment), and 27 to 30 (no cognitive impairment) for MMSE scores; 0 to 19 (severe cognitive impairment), 20 to 24 (mild cognitive impairment), and 25 to 30 (no cognitive impairment) for MoCA scores . In this analysis, a score of <27 on the MMSE and <25 on the MoCA indicated cognitive impairment.…”

Section: Methodsmentioning

confidence: 99%

Serum Matrix Metalloproteinase‐9 and Cognitive Impairment After Acute Ischemic Stroke

Zhong

et al. 2018

JAHA

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BackgroundThe impact of serum matrix metalloproteinases‐9 (MMP‐9) on cognitive impairment after ischemic stroke is unclear. We aimed to investigate the association between serum MMP‐9 in the short‐term acute phase of ischemic stroke and cognitive impairment at 3 months.Methods and ResultsOur study was based on a subsample from the CATIS (China Antihypertensive Trial in Acute Ischemic Stroke); a total of 558 patients with serum MMP‐9 levels from 7 of 26 participating sites of the trial were included in this analysis. Cognitive impairment severity was categorized as severe, mild, or none (Mini‐Mental State Examination score, <23, 23–26, or ≥27, respectively; Montreal Cognitive Assessment score, <20, 20–24, or ≥25, respectively). Cognitive impairment was defined as a score of <27 for Mini‐Mental State Examination or <25 for Montreal Cognitive Assessment. According to Mini‐Mental State Examination score, 143 participants (25.6%) had mild cognitive impairment and 153 (27.4%) had severe cognitive impairment at 3 months. After adjustment for age, National Institutes of Health stroke score, education, and other covariates, the odds ratio for the highest quartile of serum MMP‐9 compared with the lowest quartile was 3.20 (95% confidence interval, 1.87–5.49) for cognitive impairment. Multiple‐adjusted spline regression model showed a linear association between MMP‐9 levels and cognitive impairment (P<0.001 for linearity). Sensitivity and subgroup analyses further confirmed these results. Similar significant findings were observed when cognitive impairment was defined by Montreal Cognitive Assessment score.ConclusionsIncreased serum MMP‐9 levels in the short‐term phase of ischemic stroke were associated with 3‐month cognitive impairment, independently of established risk factors.

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Cognitive function in stroke survivors: A 10-year follow-up study

Cited by 100 publications

References 39 publications

Gait Change Is Associated with Cognitive Outcome after an Acute Ischemic Stroke

Gait Change Is Associated with Cognitive Outcome after an Acute Ischemic Stroke

Temporal Trends of Stroke Epidemiology in Southern Sweden: A Population-Based Study on Stroke Incidence and Early Case-Fatality

Serum Matrix Metalloproteinase‐9 and Cognitive Impairment After Acute Ischemic Stroke

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