Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2021
Temporal Changes in Cognitive Function in Early Recovery Phase of the Stroke.
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Dharmasaroja Pornpatr A
Аннотация
OBJECTIVES: Only a few studies longitudinally evaluated all cognitive domains after acute stroke. The purpose was to study the changes in cognitive function after acute stroke.
MATERIALS AND METHODS: Cognitive assessment, using Thai mental state examination (TMSE) and Montreal Cognitive Assessment (MOCA), was performed at the acute stroke, and at 3 and 6 months after stroke. Cognitive domains were evaluated by MOCA subcategory score. TMSE and MOCA were compared at different stages of stroke and in among those with normal cognition (NC), vascular mild cognitive impairment (VMCI) and vascular dementia (VAD).
RESULTS: 138 patients were included. At 6 months, 32 patients (23%) had NC. VMCI and VAD were diagnosed in 76 patients (55%), and 30 patients (22%), respectively. Total scores of TMSE and MOCA were higher at 3 months as compared to at the acute stroke (TMSE; 24.85 vs 23.01, p-value <0.001, MOCA; 19.30 vs 16.49, p-value <0.001), and higher TMSE, but not MOCA, at 6 months as compared to at 3 months (TMSE; 25.35 vs 24.85, p-value= 0.021, MOCA; 19.04 vs 19.30, p-value= 0.058). Changes in total scores at early stroke were highest in NC. VMCI and VAD patients had cognitive impairment in all cognitive domains.
CONCLUSIONS: Cognitive impairment was highest at the acute stroke and improved during early recovery. The greatest rate of improvement occurred within 3 months. Improvement was found in all cognitive domains.
MATERIALS AND METHODS: Cognitive assessment, using Thai mental state examination (TMSE) and Montreal Cognitive Assessment (MOCA), was performed at the acute stroke, and at 3 and 6 months after stroke. Cognitive domains were evaluated by MOCA subcategory score. TMSE and MOCA were compared at different stages of stroke and in among those with normal cognition (NC), vascular mild cognitive impairment (VMCI) and vascular dementia (VAD).
RESULTS: 138 patients were included. At 6 months, 32 patients (23%) had NC. VMCI and VAD were diagnosed in 76 patients (55%), and 30 patients (22%), respectively. Total scores of TMSE and MOCA were higher at 3 months as compared to at the acute stroke (TMSE; 24.85 vs 23.01, p-value <0.001, MOCA; 19.30 vs 16.49, p-value <0.001), and higher TMSE, but not MOCA, at 6 months as compared to at 3 months (TMSE; 25.35 vs 24.85, p-value= 0.021, MOCA; 19.04 vs 19.30, p-value= 0.058). Changes in total scores at early stroke were highest in NC. VMCI and VAD patients had cognitive impairment in all cognitive domains.
CONCLUSIONS: Cognitive impairment was highest at the acute stroke and improved during early recovery. The greatest rate of improvement occurred within 3 months. Improvement was found in all cognitive domains.