Post-stroke cognitive impairment (results of a 5-year follow-up)

Prior stroke plays an important role in the development of cognitive impairment (CI), the prevention of which requires detailed study.Patients and methods. A total of 350 patients (mean age, 65±17.7 years; 49% men) who had experienced a stroke with a small degree of neurological deficit were followe...

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Main Authors: S. V. Verbitskaya, V. A. Parfenov, V. A. Reshetnikov, V. V. Kozlov, A. R. Kabaeva
Format: Article
Language:Russian
Published: IMA-PRESS LLC 2018-04-01
Series:Неврология, нейропсихиатрия, психосоматика
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Online Access:https://nnp.ima-press.net/nnp/article/view/828
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Summary:Prior stroke plays an important role in the development of cognitive impairment (CI), the prevention of which requires detailed study.Patients and methods. A total of 350 patients (mean age, 65±17.7 years; 49% men) who had experienced a stroke with a small degree of neurological deficit were followed up. Cognitive functions were evaluated using the Mini-Mental State Examination (MMSE), Mattis dementia rating scale, the clock drawing test, the test on memorizing 12 words, and the Schulte table. During 5 years of follow-up, 61 (17.4%) patients died, including 45 (12.8%) from recurrent stroke; 89 recurrent strokes developed.Results. The first examination did not reveal CI in 59 (17%) patients; 73 (21%) were found to have marked CI (mild or moderate dementia). After 1, 3, and 5years of follow-up, the proportion of patients with marked CI increased up to 23.2, 29.5, and 34.5%, respectively. Within 5 years, there was an average decline of 2 MMSE scores. The maximum decrease in cognitive functions was seen in patients who had experienced a recurrent stroke, but this also occurred in the absence of a stroke. Cognitive functions were substantially better in a group of patients with blood pressure (BP) normalization.Conclusion. The 5-year follow-up has shown that post-stroke CI gradually progresses, which is associated with the progression of both vascular disease and a concomitant neurodegenerative process. BP normalization during antihypertensive therapy contributes to the prevention of progressive post-stroke CI.
ISSN:2074-2711
2310-1342