Title: Predictors of Cognitive Impairment in Stroke Servivors

Authors: Gharib F. Mohamed, HemedM. Baddary, Mohamed N. Thabit, A. Ammar Ghaibeh, Alaaeldin Sedky Bakhit Farrag, Ahmad G. Arafa

 DOI:  http://dx.doi.org/10.18535/jmscr/v4i8.14

Abstract

The aim of this study is to determine the various risk factors and stroke characteristics that play a role in development of poststrokecongnitive impairment. A total of 119 chronic stroke patients were included in the study. Patients with history of psychiatric, medical or taking drugs that cause cognitive impairement were excluded from the study. The stroke patients were classified into normal or having mild, moderate and severe congnitiveimpairement according to the mini-mental state examination. Demographic variables and stroke risk factors including; age, sex, hypertension, diabetes mellitus, smoking, cardiac diseases, prior history of stroke or transient ischemic attacks were assessed. Various stroke symptomatology, history of delirium with the onset of stroke, and history of poststroke epilepsy were assessed.Barthel index and Beck depression scale were used to assess the global poststroke disability and poststroke depression. The lesion type, site, side, and size were assessed from the relevant brain imaging. The role of various previously mentioned factors in development of poststroke cognitive impairement were tested using the appropriate statistical test and C 4.5 decision tree for those factors were done.elderly stroke patients with multiple large sized strokes especially in the left hemisphere, those with cortical lesion, those associated with delirious onset, those who develop poststroke epilepsy and/or depression, and finally those patients with severe poststrokediseability are more likely to suffer psotstroke cognitive impairement.Early cognitive rehabilition methods and medical treatment with antidementia medications should be provided for patients with the associated previously mentioned factors.

Keywords: Stroke, Cognitive, Dementia, Predictors.

References

 

1.      El-Tallawy, H.N., W.M. Farghaly, G.A. Shehata, N.M. Abdel-Hakeem, T.A. Rageh, R. Badry, and M.R. Kandil, Epidemiology of non-fatal cerebrovascular stroke and transient ischemic attacks in Al Quseir, Egypt. Clin Interv Aging, 2013. 8: p. 1547-51.

2.      Farghaly, W.M., H.N. El-Tallawy, G.A. Shehata, T.A. Rageh, N.M. Abdel-Hakeem, M.A. Elhamed, B.M. Al-Fawal, and R. Badry, Epidemiology of nonfatal stroke and transient ischemic attack in Al-Kharga District, New Valley, Egypt. Neuropsychiatr Dis Treat, 2013. 9: p. 1785-90.

3.      Khedr, E.M., N.A. Elfetoh, G. Al Attar, M.A. Ahmed, A.M. Ali, A. Hamdy, M.R. Kandil, and H. Farweez, Epidemiological study and risk factors of stroke in Assiut Governorate, Egypt: community-based study. Neuroepidemiology, 2013. 40(4): p. 288-94.

4.      Ivan, C.S., S. Seshadri, A. Beiser, R. Au, C.S. Kase, M. Kelly-Hayes, and P.A. Wolf, Dementia after stroke: the Framingham Study. Stroke, 2004. 35(6): p. 1264-8.

5.      Barba, R., S. Martinez-Espinosa, E. Rodriguez-Garcia, M. Pondal, J. Vivancos, and T. Del Ser, Poststroke dementia : clinical features and risk factors. Stroke, 2000. 31(7): p. 1494-501.

6.      Spalletta, G., D. De Angelis, and C. Caltagirone, Poststroke depression and emotional incontinence. Neurology, 2000. 55(11): p. 1760-1.

7.      Kim, J.S. and S. Choi-Kwon, Poststroke depression and emotional incontinence: correlation with lesion location. Neurology, 2000. 54(9): p. 1805-10.

8.      Lamb, F., J. Anderson, M. Saling, and H. Dewey, Predictors of subjective cognitive complaint in postacute older adult stroke patients. Arch Phys Med Rehabil, 2013. 94(9): p. 1747-52.

9.      Spalletta, G., G. Guida, D. De Angelis, and C. Caltagirone, Predictors of cognitive level and depression severity are different in patients with left and right hemispheric stroke within the first year of illness. J Neurol, 2002. 249(11): p. 1541-51.

10.  Marrega, L.H., S.M. Silva, E.F. Manffra, and J.C. Nievola, Comparison between Decision Tree and Genetic Programming to distinguish healthy from stroke postural sway patterns. Conf Proc IEEE Eng Med Biol Soc, 2015. 2015: p. 6820-3.

11.  Pantano, P., F. Caramia, L. Bozzao, C. Dieler, and R. von Kummer, Delayed increase in infarct volume after cerebral ischemia: correlations with thrombolytic treatment and clinical outcome. Stroke, 1999. 30(3): p. 502-7.

12.  Abdel-Khalek, A.M., Internal consistency of an Arabic Adaptation of the Beck Depression Inventory in four Arab countries. Psychol Rep, 1998. 82(1): p. 264-6.

13.  Khedr, E.M., S.A. Hamed, H.K. El-Shereef, O.A. Shawky, K.A. Mohamed, E.M. Awad, M.A. Ahmed, G.A. Shehata, and M.A. Eltahtawy, Cognitive impairment after cerebrovascular stroke: Relationship to vascular risk factors. Neuropsychiatr Dis Treat, 2009. 5: p. 103-16.

14.  Douiri, A., A.G. Rudd, and C.D. Wolfe, Prevalence of poststroke cognitive impairment: South London Stroke Register 1995-2010. Stroke, 2013. 44(1): p. 138-45.

15.  Stoquart-ElSankari, S., O. Baledent, C. Gondry-Jouet, M. Makki, O. Godefroy, and M.E. Meyer, Aging effects on cerebral blood and cerebrospinal fluid flows. J Cereb Blood Flow Metab, 2007. 27(9): p. 1563-72.

16.  Farrag, A.K., E.M. Khedr, H. Abdel-Aleem, and T.A. Rageh, Effect of surgical menopause on cognitive functions. Dement Geriatr Cogn Disord, 2002. 13(3): p. 193-8.

17.  Vinters, H.V., W.G. Ellis, C. Zarow, B.W. Zaias, W.J. Jagust, W.J. Mack, and H.C. Chui, Neuropathologic substrates of ischemic vascular dementia. J Neuropathol Exp Neurol, 2000. 59(11): p. 931-45.

18.  De Reuck, J. and G. Van Maele, Cognitive impairment and seizures in patients with lacunar strokes. Eur Neurol, 2009. 61(3): p. 159-63.

19.  Mitasova, A., M. Kostalova, J. Bednarik, R. Michalcakova, T. Kasparek, P. Balabanova, L. Dusek, S. Vohanka, and E.W. Ely, Poststroke delirium incidence and outcomes: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Crit Care Med, 2012. 40(2): p. 484-90.

20.  Minett, T.S., J.L. Dean, M. Firbank, P. English, and J.T. O'Brien, Subjective memory complaints, white-matter lesions, depressive symptoms, and cognition in elderly patients. Am J Geri. Psychiatry, 2005. 13(8): p. 665-71.

Corresponding Author

Mohamed Nasreldin Thabit Hamdoon

Neurology Department, Sohag University Hospital, Sohag University, Madinat Nasser,

Sohag, Egypt. Postal Code: 82524, Tel: +201004934646

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.