Prevalence and Determinants of Postischemic Stroke Cognitive Impairment in Older Persons

Abstract

Background: It is essential to identify the burden of poststroke cognitive impairment (PSCI) and to frame strategies for its prevention and progression in a developing country. AIM: The aim of the study was to estimate the prevalence and identify the risk factors of PSCI in older persons who survived an ischemic stroke. MATERIALS AND METHODS: Patients with acute stroke satisfying the inclusion criteria were recruited. Clinical and demographic data, baseline functional capacity, and cognition as assessed by the Barthel index and the Informant Questionnaire on Cognitive Decline in the Elderly, respectively, were collected. The patients were then administered the Confusion Assessment Method, Mini-Cog, Montreal Cognitive Assessment (MoCA), and Frontal Assessment Battery within the 1st week of stroke and were reassessed at 1 month. The diagnosis of PSCI was done based on MoCA score within 1 week and at 1 month after stroke, and the analysis of risk factors for PSCI was done based on MoCA score at 1 month. Results: The prevalence of PSCI in this study was 63.8% within the 1st week and 71.8% at 1 month after the stroke. Lower educational and occupational status, higher Charlson Comorbidity Index, presence of delirium during the 1st week after stroke, poststroke depression, higher National Institutes of Health Stroke Scale score, and higher Modified Rankin Scale score were found to be risk factors for the development of PSCI on univariate analysis. Lower socioeconomic status was found to be a risk factor on both univariate and multivariate analyses. Conclusion: The prevalence of PSCI was 71.8% at 1 month after stroke. Lower socioeconomic status was found to be a risk factor for PSCI. Larger studies are needed to identify various modifiable risk factors, to improve the quality of life in older stroke survivors.

Keywords

• older persons
• poststroke cognitive impairment
• prevalence