Clinical neurology and neurosurgery · 2025
Cognitive assessment in patients with acute stroke: Exploring early intervention for dementia.
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Ishiwata Akiko, Nogami Akane, Nishimura Takuya, Kanamaru Takuya, Suzuki Kentaro, Suda Satoshi
Аннотация
BACKGROUND: Early detection of cognitive impairment in patients with acute stroke could improve dementia treatment; however, such testing is uncommon. This study aimed to assess cognitive testing feasibility in patients with acute stroke and identify patient characteristics associated with testing ability.
METHODS: 291 patients with suspected acute stroke were admitted to our hospital between December 2016 and May 2017. Of these, 280 were diagnosed with stroke (median [interquartile range] age 73 [63-81] years; 70 % male; 11 % with prior cognitive decline) and included in the study. Patients able or unable to complete three cognitive function tests were classified as the testable or untestable group, respectively.
RESULTS: Among the 280 patients, 72 % completed all three cognitive tests a mean of 4 [3-5] days after onset. Significant differences were found between the testable and untestable groups, particularly in age (70 [61-80] vs. 77 [69-84], p < 0.0001), Informant Questionnaire on Cognitive Decline in the Elderly score (78 [78-83] vs. 84 [78-96], p = 0.012), and National Institutes of Health Stroke Scale (NIHSS) score at onset (3 [1-6] vs. 13 [4-18], p < 0.0001). Advanced age, a higher NIHSS score, and pre-stroke cognitive decline were independent risk factors for the inability to undergo testing.
CONCLUSIONS: Cognitive testing was feasible in 72 % of patients with acute stroke, particularly those who were younger, had normal pre-stroke cognitive function, and experienced mild strokes. Early cognitive assessment may enable timely dementia detection and treatment.
METHODS: 291 patients with suspected acute stroke were admitted to our hospital between December 2016 and May 2017. Of these, 280 were diagnosed with stroke (median [interquartile range] age 73 [63-81] years; 70 % male; 11 % with prior cognitive decline) and included in the study. Patients able or unable to complete three cognitive function tests were classified as the testable or untestable group, respectively.
RESULTS: Among the 280 patients, 72 % completed all three cognitive tests a mean of 4 [3-5] days after onset. Significant differences were found between the testable and untestable groups, particularly in age (70 [61-80] vs. 77 [69-84], p < 0.0001), Informant Questionnaire on Cognitive Decline in the Elderly score (78 [78-83] vs. 84 [78-96], p = 0.012), and National Institutes of Health Stroke Scale (NIHSS) score at onset (3 [1-6] vs. 13 [4-18], p < 0.0001). Advanced age, a higher NIHSS score, and pre-stroke cognitive decline were independent risk factors for the inability to undergo testing.
CONCLUSIONS: Cognitive testing was feasible in 72 % of patients with acute stroke, particularly those who were younger, had normal pre-stroke cognitive function, and experienced mild strokes. Early cognitive assessment may enable timely dementia detection and treatment.