Determinants of post-stroke cognitive impairment

F. Arba, T. Quinn, G.J. Hankey, D. Inzitari, M. Ali, K.R. Lees, VISTA Collaboration

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Abstract

Background: Post stroke cognitive impairment (PSCI) occurs commonly and is linked with development of dementia. It is not clear whether acute stroke factors are associated with development of PSCI. We investigated the relationship between cardiovascular risk factors, stroke symptoms and presence of PSCI at 1 and 3 years after stroke.
Methods: We accessed anonymised data from the Virtual International Stroke Trial Archive (VISTA), including demographic and clinical variables. PSCI was defined as a Mini Mental State Examination (MMSE) score of =26. We assessed univariate relationships between baseline stroke symptoms and PSCI at 1 and 3 years following stroke, retaining the significant and relevant clinical factors as
covariates in a final adjusted logistic regression model.
Results: We analysed data on 5435 patients. Mean (±SD) age was 62.6 (±12.6) years, 3476 (65%) patients were male. Follow up data were available for 2270 and 1294 at one and three years, respectively. After adjusting for age, stroke severity, hypertension, diabetes and type of qualifying event, initial stroke impairment (leg paralysis) was associated with increased rate of PSCI at one year
(OR=1.62; 95% CI=1.20-2.20) and at three years (OR=1.95; 95% CI=1.23-3.09). Associations were consistent on subgroup analysis restricted to ischaemic stroke and transient ischaemic attack (N=4992).
Conclusions: Early clinical features are associated with development of PSCI up to 3 years after stroke, with initial stroke impairment consistently associated with PSCI.
Original languageEnglish
Pages (from-to)603-607
Number of pages5
JournalActa Neurologica Scandinavica
Volume135
Issue number6
Early online date13 Jul 2016
DOIs
Publication statusPublished - Jun 2017

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Stroke
Cognitive Dysfunction
Logistic Models
Paraplegia
Transient Ischemic Attack
Dementia
Demography

Keywords

  • stroke
  • cognitive impairment
  • dementia

Cite this

Arba, F., Quinn, T., Hankey, G. J., Inzitari, D., Ali, M., Lees, K. R., & Collaboration, VISTA. (2017). Determinants of post-stroke cognitive impairment. Acta Neurologica Scandinavica, 135(6), 603-607. https://doi.org/10.1111/ane.12637
Arba, F. ; Quinn, T. ; Hankey, G.J. ; Inzitari, D. ; Ali, M. ; Lees, K.R. ; Collaboration, VISTA. / Determinants of post-stroke cognitive impairment. In: Acta Neurologica Scandinavica. 2017 ; Vol. 135, No. 6. pp. 603-607.
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Arba, F, Quinn, T, Hankey, GJ, Inzitari, D, Ali, M, Lees, KR & Collaboration, VISTA 2017, 'Determinants of post-stroke cognitive impairment', Acta Neurologica Scandinavica, vol. 135, no. 6, pp. 603-607. https://doi.org/10.1111/ane.12637

Determinants of post-stroke cognitive impairment. / Arba, F.; Quinn, T.; Hankey, G.J.; Inzitari, D.; Ali, M.; Lees, K.R.; Collaboration, VISTA.

In: Acta Neurologica Scandinavica, Vol. 135, No. 6, 06.2017, p. 603-607.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Determinants of post-stroke cognitive impairment

AU - Arba, F.

AU - Quinn, T.

AU - Hankey, G.J.

AU - Inzitari, D.

AU - Ali, M.

AU - Lees, K.R.

AU - Collaboration, VISTA

N1 - AAM: 12m embargo Note difference in title between AAM and published version; catalogued according to AAM in Pure. Exception form sent, email from author in SAN re no exception. ET 20-9-17

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Y1 - 2017/6

N2 - Background: Post stroke cognitive impairment (PSCI) occurs commonly and is linked with development of dementia. It is not clear whether acute stroke factors are associated with development of PSCI. We investigated the relationship between cardiovascular risk factors, stroke symptoms and presence of PSCI at 1 and 3 years after stroke.Methods: We accessed anonymised data from the Virtual International Stroke Trial Archive (VISTA), including demographic and clinical variables. PSCI was defined as a Mini Mental State Examination (MMSE) score of =26. We assessed univariate relationships between baseline stroke symptoms and PSCI at 1 and 3 years following stroke, retaining the significant and relevant clinical factors ascovariates in a final adjusted logistic regression model.Results: We analysed data on 5435 patients. Mean (±SD) age was 62.6 (±12.6) years, 3476 (65%) patients were male. Follow up data were available for 2270 and 1294 at one and three years, respectively. After adjusting for age, stroke severity, hypertension, diabetes and type of qualifying event, initial stroke impairment (leg paralysis) was associated with increased rate of PSCI at one year(OR=1.62; 95% CI=1.20-2.20) and at three years (OR=1.95; 95% CI=1.23-3.09). Associations were consistent on subgroup analysis restricted to ischaemic stroke and transient ischaemic attack (N=4992).Conclusions: Early clinical features are associated with development of PSCI up to 3 years after stroke, with initial stroke impairment consistently associated with PSCI.

AB - Background: Post stroke cognitive impairment (PSCI) occurs commonly and is linked with development of dementia. It is not clear whether acute stroke factors are associated with development of PSCI. We investigated the relationship between cardiovascular risk factors, stroke symptoms and presence of PSCI at 1 and 3 years after stroke.Methods: We accessed anonymised data from the Virtual International Stroke Trial Archive (VISTA), including demographic and clinical variables. PSCI was defined as a Mini Mental State Examination (MMSE) score of =26. We assessed univariate relationships between baseline stroke symptoms and PSCI at 1 and 3 years following stroke, retaining the significant and relevant clinical factors ascovariates in a final adjusted logistic regression model.Results: We analysed data on 5435 patients. Mean (±SD) age was 62.6 (±12.6) years, 3476 (65%) patients were male. Follow up data were available for 2270 and 1294 at one and three years, respectively. After adjusting for age, stroke severity, hypertension, diabetes and type of qualifying event, initial stroke impairment (leg paralysis) was associated with increased rate of PSCI at one year(OR=1.62; 95% CI=1.20-2.20) and at three years (OR=1.95; 95% CI=1.23-3.09). Associations were consistent on subgroup analysis restricted to ischaemic stroke and transient ischaemic attack (N=4992).Conclusions: Early clinical features are associated with development of PSCI up to 3 years after stroke, with initial stroke impairment consistently associated with PSCI.

KW - stroke

KW - cognitive impairment

KW - dementia

U2 - 10.1111/ane.12637

DO - 10.1111/ane.12637

M3 - Article

VL - 135

SP - 603

EP - 607

JO - Acta Neurologica Scandinavica

JF - Acta Neurologica Scandinavica

SN - 0001-6314

IS - 6

ER -

Arba F, Quinn T, Hankey GJ, Inzitari D, Ali M, Lees KR et al. Determinants of post-stroke cognitive impairment. Acta Neurologica Scandinavica. 2017 Jun;135(6):603-607. https://doi.org/10.1111/ane.12637