Increased risk of cognitive impairment 3 months after mild to moderate first-ever stroke: a Community-Based Prospective Study of Nonaphasic English-Speaking Survivors

Stroke. 2003 May;34(5):1136-43. doi: 10.1161/01.STR.0000069161.35736.39. Epub 2003 Apr 17.

Abstract

Background and purpose: Results of hospital-based studies indicate a high risk of cognitive impairment 3 months after stroke. There are no comprehensive data on this issue from prospective community-based studies comparing first-ever stroke patients with stroke-free subjects.

Methods: We administered a comprehensive neuropsychological battery to 99 community-based nonaphasic survivors of first-ever stroke at 3 months and 99 age- and sex-matched (1:1) stroke-free individuals. Domain-specific cognitive deficits were identified by blinded neuropsychological consensus.

Methods: Stroke patients were more likely to suffer any cognitive impairment (relative risk [RR], 1.5; 95% CI, 1.1 to 2.1) attributable mainly to a greater risk of single-domain cognitive impairment (RR, 2.8; 95% CI, 1.5 to 5.3) but not multiple-domain cognitive impairment (RR, 1.2; 95% CI, 0.8 to 1.9).

Conclusions: In this community-based study, a first-ever stroke of mild to moderate severity was associated with a significant risk of cognitive impairment at 3 months, even in the absence of clinical aphasia. This was due primarily to an increased risk of solitary deficits rather than generalized deficits.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cognition Disorders / epidemiology*
  • Cognition Disorders / etiology
  • Cohort Studies
  • Comorbidity
  • Cross-Sectional Studies
  • Diabetes Mellitus / epidemiology
  • Female
  • Follow-Up Studies
  • Hemiplegia / epidemiology
  • Hemiplegia / etiology
  • Humans
  • Hyperlipidemias / epidemiology
  • Hypertension / epidemiology
  • Male
  • Memory Disorders / epidemiology
  • Memory Disorders / etiology
  • Middle Aged
  • Neuropsychological Tests
  • Patient Selection
  • Prospective Studies
  • Risk
  • Selection Bias
  • Severity of Illness Index
  • Single-Blind Method
  • Stroke / complications*
  • Stroke / psychology
  • Survivors
  • Victoria / epidemiology