Domain-specific cognitive recovery after first-ever stroke: A follow-up study of 111 cases

Abstract

The objective of this study is to examine the prognosis of acute cognitive disorders post-stroke, and to evaluate which clinical factors predict domain-specific cognitive recovery. We followed the course of cognitive functioning in 111 stroke patients and 77 healthy controls by administering two neuropsychological examinations with a 6 to 10 month interval (mean interval, 7.5 6 1.3 months). The baseline examination was administered within three weeks post-stroke (mean interval, 7.9 6 4.2 days). To examine determinants of domain-specific cognitive recovery, we recorded vascular risk factors, clinical variables, and lesion characteristics. Recovery in visual perception0construction (83%) and visual memory (78%) was the most common. An acute cognitive disorder predicted a long-term disorder in the same domain (all p , .05), except for visual perception0construction. Factors associated with poor cognitive recovery were age (all p , .01), preexistent verbal ability (all p , .005), lesion locations involving the temporal (all p , .05), frontal ( p , .05) and occipital lobe (all p , .05), lesion volume ( p Յ .001), and diabetes mellitus ( p , .01). An early neuropsychological examination provides valuable information on long-term cognitive performance. The prognosis of higher-level visual disorders is the most favorable. Cognitive recovery is associated with age, preexistent ability, lesion volume, lesion location, and diabetes mellitus. (JINS, 2005, 11, 795-806.)

The Impact of Falls on Motor and Cognitive Recovery after Discharge from In-Patient Stroke Rehabilitation

“…Previous studies of cognitive deficits after stroke suggest that improvement in cognitive function is possible over time, especially within six months post-stroke; [50][51][52] however, another study suggested that cognitive deficits remain stable in the sub-acute phase of stroke. 53 In this study, the proportion of participants who scored less than 26 points on the MoCA at discharge dropped slightly by 10% at follow-up.…”

Risk factors associated with post-stroke dementia: a systematic review and meta-analysis

“…47 and there is evidence that diabetes is associated with reduced recovery of cognitive function after stroke. 48 Diabetes mellitus has been associated with various adverse health effects, and it was found that patients with diabetes mellitus were more likely than normal patients to have low MMSE 49 reduced cerebral blood flow associated with impaired cerebral auto regulation, increased blood viscosity, and greater prevalence of underlying intracranial large-or small-artery disease. 50 Similarly, the reported association between stroke patients with and without diabetes mellitus of other studies 20,21,26,30,31,39,46 found that diabetes mellitus associated with an increased prevalence of post-stroke dementia.…”

Estado neurológico e cognição de pacientes pós-acidente vascular cerebral

“…Since CVA is one of the main causes of this type of impairment, the incidence of cogniti ve disorders in the populati on surviving a CVA varies from 12% to 56% (6)(7) . CVA can be considered the main cause of cogniti ve impairment in elderly individuals, aff ecti ng about 50% of pati ents, both in the acute and chronic phases (7)(8) .…”