Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
The Occurrence and Longitudinal Changes of Cognitive Impairment After Acute Ischemic Stroke
First author：Xiaoling Liao
Corresponding author：Yongjun Wang
essential_information
- Person in charge：Xiaoling Liao
- Data Sources： CNSR-Ⅲ
- Number of papers：CNSR-Ⅲ20190211
- Published time：2020-03-26
2020-03-26
Published articles
Journal：Neuropsychiatric Disease and Treatment
Publication type: Original Research Article
IF(IF): 2.57
PMID: 32273707 Link To Pubmed Full text Download
Background And Purpose
More and more evidence suggests that cognitive impairment after stroke are closely related to the quality of life of stroke patients. There is currently no nationwide multi-center survey of cognitive impairment after acute ischemic stroke(AIS) in China, except data from some cities. The primary aim of this study is to investigate the occurrence and longitudinal changes of cognitive impairment at different stages after acute ischemic stroke in Chinese patients.
Method
The data of this study comes from the Impairment of CognitiON and Sleep after acute ischemic stroke or transient ischemic attack in Chinese patients study(ICONS), a nationwide multicenter prospective registry that recruited consecutive AIS or transient ischemic attack in-hospital patients within 7 days after onset. Patients were followed for Montreal Cognitive Assessment (MoCA) scale at 2-week(2w), 3-months (3m) and 12-months(12m). CI was defined as MoCA score≦22. No cognitive impairment(NCI) was defined as MoCA score>22.
Conclusion
CI had a relatively high occurrence at 2w to 12m after AIS. CI at 3m and 12m was significantly lower than that at 2w after stroke. The occurrence of abnormalities and recovery probability for different cognitive items also differed greatly.
Main results
A total of 2432 AIS patients were enrolled in this study. Overall, 72.94% patients were male and the average age was 60.95 years. Median National Institutes of Health Stroke Scale score was 3. The occurrence rate of CI was 52.38%, 35.55% and 34.16% at 2w, 3m and 12m. Among patients with CI at 2w and 3m, 39.9% and 27.9% of patients returned to NCI at next follow-up point. At 3m and 12m follow-up, there were also 9.6% and 12.7% new CI patients. The two cognitive items with the highest abnormal rate were “Delayed recall” (89.35%, 83.33% and 82.80%) and “Visuospatial/executive” (78.91%, 73.42% and 70.08%). The cognitive item with the highest percentage of improved patients was “Orientation” (60.91%-76.68%), and the cognitive item with the lowest percentage of improved patients was “Language”(35.85%-44.50%).