Profile of and risk factors for poststroke cognitive impairment in diverse ethnoregional groups.

Journal: Neurology

Volume: 93

Issue: 24

Year of Publication: 2020

Affiliated Institutions:  From the Centre for Healthy Brain Ageing (J.W.L., J.D.C., R.J.C., H.B., D.M.L., N.A.K., P.S.S.), University of New South Wales, Sydney, Australia; Department of Neurology and Laboratory of Functional Neurosciences (O.G., M.B., M.R.), University Hospital of Amiens, France; Clinical Neurosciences (H.J., S.M., T.E.), Neurology, University of Helsinki and Helsinki University Hospital, Finland; Department of Internal Medicine (S.M.), Gerontology and Geriatrics Section, and Department of Cardiology (J.W.J.), Leiden University Medical Center, the Netherlands; Department of Neurology (S.M., B.S.), Feinberg School of Medicine, Northwestern University, Chicago, IL; Department of Neurology (H.-J.B.), Seoul National University School of Medicine, Seoul National University Bundang Hospital, Seongnam; Department of Neurology (J.-S.L., B.-C.L.), Hallym University Sacred Heart Hospital, Anyang, Republic of Korea; Department of Psychiatry and Neuropsychology (S.K., E.D.), School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University; Department of Neurology (J.S.), Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, the Netherlands; Memory Aging and Cognition Centre (C.C., X.X., E.J.C.), Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore; Centre for Population Health Sciences (X.X.), Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Neuroscience and Ageing Research Unit (R.O.A., A.O.), Institute for Advanced Medical Research and Training, and Department of Medicine (R.O.A.), College of Medicine, University of Ibadan, Nigeria; Institute of Neuroscience (R.N.K.), Newcastle University, Newcastle Upon Tyne, UK; Peninsula Clinical School (V.K.S., C.M.), Central Clinical School, Monash University; Department of Aged Care (C.M.), Alfred Health, Melbourne, Australia; National Neuroscience Institute (N.K., R.J.C.); Duke-NUS Medical School (N.K.), Singapore; Dementia Collaborative Research Centre (H.B., P.S.S.), University of New South Wales, Sydney, Australia; and University of Lille (R.B., S.B., H.H.), Inserm, CHU Lille, U-Degenerative & Vascular Cognitive Disorders, France. From the Centre for Healthy Brain Ageing (J.W.L., J.D.C., R.J.C., H.B., D.M.L., N.A.K., P.S.S.), University of New South Wales, Sydney, Australia; Department of Neurology and Laboratory of Functional Neurosciences (O.G., M.B., M.R.), University Hospital of Amiens, France; Clinical Neurosciences (H.J., S.M., T.E.), Neurology, University of Helsinki and Helsinki University Hospital, Finland; Department of Internal Medicine (S.M.), Gerontology and Geriatrics Section, and Department of Cardiology (J.W.J.), Leiden University Medical Center, the Netherlands; Department of Neurology (S.M., B.S.), Feinberg School of Medicine, Northwestern University, Chicago, IL; Department of Neurology (H.-J.B.), Seoul National University School of Medicine, Seoul National University Bundang Hospital, Seongnam; Department of Neurology (J.-S.L., B.-C.L.), Hallym University Sacred Heart Hospital, Anyang, Republic of Korea; Department of Psychiatry and Neuropsychology (S.K., E.D.), School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University; Department of Neurology (J.S.), Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, the Netherlands; Memory Aging and Cognition Centre (C.C., X.X., E.J.C.), Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore; Centre for Population Health Sciences (X.X.), Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Neuroscience and Ageing Research Unit (R.O.A., A.O.), Institute for Advanced Medical Research and Training, and Department of Medicine (R.O.A.), College of Medicine, University of Ibadan, Nigeria; Institute of Neuroscience (R.N.K.), Newcastle University, Newcastle Upon Tyne, UK; Peninsula Clinical School (V.K.S., C.M.), Central Clinical School, Monash University; Department of Aged Care (C.M.), Alfred Health, Melbourne, Australia; National Neuroscience Institute (N.K., R.J.C.); Duke-NUS Medical School (N.K.), Singapore; Dementia Collaborative Research Centre (H.B., P.S.S.), University of New South Wales, Sydney, Australia; and University of Lille (R.B., S.B., H.H.), Inserm, CHU Lille, U-Degenerative & Vascular Cognitive Disorders, France. p.sachdev@unsw.edu.au.

Abstract summary 

To address the variability in prevalence estimates and inconsistencies in potential risk factors for poststroke cognitive impairment (PSCI) using a standardized approach and individual participant data (IPD) from international cohorts in the Stroke and Cognition Consortium (STROKOG) consortium.We harmonized data from 13 studies based in 8 countries. Neuropsychological test scores 2 to 6 months after stroke or TIA and appropriate normative data were used to calculate standardized cognitive domain scores. Domain-specific impairment was based on percentile cutoffs from normative groups, and associations between domain scores and risk factors were examined with 1-stage IPD meta-analysis.In a combined sample of 3,146 participants admitted to hospital for stroke (97%) or TIA (3%), 44% were impaired in global cognition and 30% to 35% were impaired in individual domains 2 to 6 months after the index event. Diabetes mellitus and a history of stroke were strongly associated with poorer cognitive function after covariate adjustments; hypertension, smoking, and atrial fibrillation had weaker domain-specific associations. While there were no significant differences in domain impairment among ethnoracial groups, some interethnic differences were found in the effects of risk factors on cognition.This study confirms the high prevalence of PSCI in diverse populations, highlights common risk factors, in particular diabetes mellitus, and points to ethnoracial differences that warrant attention in the development of prevention strategies.

Authors & Co-authors:  Lo Jessica W JW Crawford John D JD Desmond David W DW Godefroy Olivier O Jokinen Hanna H Mahinrad Simin S Bae Hee-Joon HJ Lim Jae-Sung JS Köhler Sebastian S Douven Elles E Staals Julie J Chen Christopher C Xu Xin X Chong Eddie J EJ Akinyemi Rufus O RO Kalaria Rajesh N RN Ogunniyi Adesola A Barbay Mélanie M Roussel Martine M Lee Byung-Chul BC Srikanth Velandai K VK Moran Christopher C Kandiah Nagaendran N Chander Russell J RJ Sabayan Behnam B Jukema J Wouter JW Melkas Susanna S Erkinjuntti Timo T Brodaty Henry H Bordet Régis R Bombois Stéphanie S Hénon Hilde H Lipnicki Darren M DM Kochan Nicole A NA Sachdev Perminder S PS

Study Outcome 

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Citations :  Pendlebury ST, Rothwell PM. Prevalence, incidence, and factors associated with pre-stroke and post-stroke dementia: a systematic review and meta-analysis. Lancet Neurol 2009;8:1006–1018.
Authors :  36
Identifiers
Doi : 10.1212/WNL.0000000000008612
SSN : 1526-632X
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
Study Design
Cross Sectional Study
Study Approach
Country of Study
Publication Country
United States