Cognitive decline before and after a first-ever stroke in Africans.

Journal: Acta neurologica Scandinavica

Volume: 144

Issue: 3

Year of Publication: 2021

Affiliated Institutions:  Department of Psychiatry, College of Medicine, World Health Organization (WHO) Collaborating centre for Research and Training in Mental health, Neuroscience, and Substance abuse, University of Ibadan, Ibadan, Nigeria. Division of Neurology, Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria. Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria.

Abstract summary 

There is a knowledge gap on the impact of pre-existing cognitive decline on poststroke decline in indigenous Africans. We describe the trajectories of domain-specific cognitive and activities of daily life (ADL) functioning across the first year of stroke in Nigerians with pre-existing cognitive decline.Prospective observational study. Prestroke cognitive decline was ascertained retrospectively using the 16-item Informant Questionnaire for Cognitive Decline in the Elderly (IQCODE). Assessments for global cognition, learning, memory, executive and ADL functioning were conducted at 3 time points using the Mini-Mental state examination (MMSE), 10-words list learning and delayed recall test (10 WDRT), Animal naming test and Barthel index, respectively.Among 150 stroke survivors, prestroke cognitive decline was found in 25 (16.7%, 95% C.I = 11.5%-23.6%). In linear regression analyses adjusting for the effect of age, education, stroke severity and comorbid diabetes mellitus, prestroke cognitive decline predicted poor memory scores at one year [Adjusted standardized mean difference (SMD) = -0.6, 95% C.I = -1.1, -0.1, p = 0.016)]. The association of prestroke cognitive decline with poststroke poor memory was substantially mediated by age (SMD = -0.9, 95% C.I = -1.4, -0.4, p < 0.001).Pre-existing cognitive decline in this sample was associated with an age-mediated poor memory function at one-year poststroke. Early institution of targeted cognitive rehabilitation in stroke survivors with pre-existing cognitive decline may reduce the neurocognitive burden of stroke in Black Africans.

Authors & Co-authors:  Ojagbemi Akin A Bello Toyin T Owolabi Mayowa M Baiyewu Olusegun O

Study Outcome 

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Statistics
Citations :  Howard VJ, Kleindorfer DO, Judd SE, et al. Disparities in stroke incidence contributing to disparities in stroke mortality. Ann Neurol. 2011;69(4):619-627.
Authors :  4
Identifiers
Doi : 10.1111/ane.13442
SSN : 1600-0404
Study Population
Male,Female
Mesh Terms
Africa
Other Terms
pre-existing dementia;prestroke symptoms;stroke burden;stroke risk factors;sub-Saharan Africa
Study Design
Cross Sectional Study
Study Approach
Country of Study
Niger
Publication Country
Denmark