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Post-stroke cognitive impairment is common even after successful clinical recovery.

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Title: Post-stroke cognitive impairment is common even after successful clinical recovery.
Authors: Jokinen, H., Melkas, S., Ylikoski, R., Pohjasvaara, T., Kaste, M., Erkinjuntti, T., Hietanen, M.
Source: European Journal of Neurology. Sep2015, Vol. 22 Issue 9, p1288-1294. 7p. 4 Charts, 1 Graph.
Subjects: Mild cognitive impairment, Stroke, Memory, Mini-Mental State Examination, Neuropsychological tests
Abstract: Background and purpose Cognitive impairment is common after stroke, but the prevalence and long-term significance of the diverse neuropsychological deficits on functional outcome are still not well known. The frequency and prognostic value of domain-specific cognitive impairments were investigated in a large cohort of ischaemic stroke patients. Methods Consecutive patients ( n = 409), aged 55-85 years, from the acute stroke unit of the Helsinki University Hospital, Finland, were evaluated with extensive clinical and neuropsychological assessments 3 months post-stroke. Impairments within nine cognitive domains were determined according to age-appropriate normative data from a random healthy population. Functional disability was evaluated with the modified Rankin scale ( mRS) 3 and 15 months post-stroke. Results In all, 83% patients showed impairment in at least one cognitive domain, whereas 50% patients were impaired in multiple (≥3) domains. In cases with excellent clinical recovery at 3 months ( mRS = 0-1, no disability), the occurrence of any cognitive impairment was 71%. Memory, visuoconstructional and executive functions were most commonly impaired. A substantially smaller proportion of patients scored below the conventional or more stringent cut-offs in the Mini-Mental State Examination ( MMSE). Domain-specific cognitive impairments were associated with functional dependence at 15 months regardless of stroke severity and other confounders. Conclusions Cognitive impairment as evaluated with a comprehensive neuropsychological assessment is prevalent in stroke survivors even with successful clinical recovery. Typically multiple domains and complex cognitive abilities are affected. MMSE is not sensitive in detecting these symptoms. Post-stroke cognitive impairment is strongly related to poor functional outcome. [ABSTRACT FROM AUTHOR]
Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Post-stroke cognitive impairment is common even after successful clinical recovery.
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  Data: <searchLink fieldCode="AR" term="%22Jokinen%2C+H%2E%22">Jokinen, H.</searchLink><br /><searchLink fieldCode="AR" term="%22Melkas%2C+S%2E%22">Melkas, S.</searchLink><br /><searchLink fieldCode="AR" term="%22Ylikoski%2C+R%2E%22">Ylikoski, R.</searchLink><br /><searchLink fieldCode="AR" term="%22Pohjasvaara%2C+T%2E%22">Pohjasvaara, T.</searchLink><br /><searchLink fieldCode="AR" term="%22Kaste%2C+M%2E%22">Kaste, M.</searchLink><br /><searchLink fieldCode="AR" term="%22Erkinjuntti%2C+T%2E%22">Erkinjuntti, T.</searchLink><br /><searchLink fieldCode="AR" term="%22Hietanen%2C+M%2E%22">Hietanen, M.</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22European+Journal+of+Neurology%22">European Journal of Neurology</searchLink>. Sep2015, Vol. 22 Issue 9, p1288-1294. 7p. 4 Charts, 1 Graph.
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  Data: <searchLink fieldCode="DE" term="%22Mild+cognitive+impairment%22">Mild cognitive impairment</searchLink><br /><searchLink fieldCode="DE" term="%22Stroke%22">Stroke</searchLink><br /><searchLink fieldCode="DE" term="%22Memory%22">Memory</searchLink><br /><searchLink fieldCode="DE" term="%22Mini-Mental+State+Examination%22">Mini-Mental State Examination</searchLink><br /><searchLink fieldCode="DE" term="%22Neuropsychological+tests%22">Neuropsychological tests</searchLink>
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  Data: Background and purpose Cognitive impairment is common after stroke, but the prevalence and long-term significance of the diverse neuropsychological deficits on functional outcome are still not well known. The frequency and prognostic value of domain-specific cognitive impairments were investigated in a large cohort of ischaemic stroke patients. Methods Consecutive patients ( n = 409), aged 55-85 years, from the acute stroke unit of the Helsinki University Hospital, Finland, were evaluated with extensive clinical and neuropsychological assessments 3 months post-stroke. Impairments within nine cognitive domains were determined according to age-appropriate normative data from a random healthy population. Functional disability was evaluated with the modified Rankin scale ( mRS) 3 and 15 months post-stroke. Results In all, 83% patients showed impairment in at least one cognitive domain, whereas 50% patients were impaired in multiple (≥3) domains. In cases with excellent clinical recovery at 3 months ( mRS = 0-1, no disability), the occurrence of any cognitive impairment was 71%. Memory, visuoconstructional and executive functions were most commonly impaired. A substantially smaller proportion of patients scored below the conventional or more stringent cut-offs in the Mini-Mental State Examination ( MMSE). Domain-specific cognitive impairments were associated with functional dependence at 15 months regardless of stroke severity and other confounders. Conclusions Cognitive impairment as evaluated with a comprehensive neuropsychological assessment is prevalent in stroke survivors even with successful clinical recovery. Typically multiple domains and complex cognitive abilities are affected. MMSE is not sensitive in detecting these symptoms. Post-stroke cognitive impairment is strongly related to poor functional outcome. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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