Cognitive impairment after cerebrovascular stroke: Relationship to vascular risk factors

Eman M Khedr1, Sherifa A Hamed1, Hala K El-Shereef2, Ola A Shawky1, Khalid A Mohamed1, Effat M Awad3, Mohamed A Ahmed2, Ghaydaa A Shehata1, Mahmoud A Eltahtawy41Department of Neurology and Psychiatry, 2Department of Internal Medicine, 3Department of Physiology, 4Department of Clinical Pathology, Ass...

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Autores principales:	Eman M Khedr, Sherifa A Hamed, Hala K El-Shereef, Ola A Shawky, Khalid A Mohamed, et al
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2009
Materias:	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/ce8fd7fa396549c285cc588c055510c3
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spelling	oai:doaj.org-article:ce8fd7fa396549c285cc588c055510c32021-12-02T04:43:00ZCognitive impairment after cerebrovascular stroke: Relationship to vascular risk factors1176-63281178-2021https://doaj.org/article/ce8fd7fa396549c285cc588c055510c32009-02-01T00:00:00Zhttp://www.dovepress.com/cognitive-impairment-after-cerebrovascular-stroke-relationship-to-vasc-a2867https://doaj.org/toc/1176-6328https://doaj.org/toc/1178-2021Eman M Khedr1, Sherifa A Hamed1, Hala K El-Shereef2, Ola A Shawky1, Khalid A Mohamed1, Effat M Awad3, Mohamed A Ahmed2, Ghaydaa A Shehata1, Mahmoud A Eltahtawy41Department of Neurology and Psychiatry, 2Department of Internal Medicine, 3Department of Physiology, 4Department of Clinical Pathology, Assiut University, Faculty of Medicine, Assiut, EgyptBackground: Cognitive decline after cerebrovascular stroke has adverse outcome consequences. Since some vascular causes can be prevented and treated, the identification of stroke-related cognitive impairment is a challenge. Patients with cognitive impairment and vascular diseases exhibit higher homocysteine (Hcy) concentrations. Whether Hcy is an independent risk factor for cognitive impairment after stoke is still in question. The objectives of this study were to determine: 1) the relative frequency of first-ever post-stroke dementia (PSD) (three months after onset) in a consecutive sample of our population, 2) the risk factors associated with PSD, and 3) the relationship between Hcy levels and PSD.Methods: Eighty-one inpatients with first-ever stroke were prospectively evaluated with a neuropsychological battery and event-related evoked potentials (P300) at onset and then after three months. A wide range of demographic, clinical, radiological and laboratory variables were examined. PSD was diagnosed if the clinical presentation fulfilled DSM-IV criteria of vascular dementia, the patient scored &le;21 on Mini Mental State Examination (MMSE) and &le;67 points on Cognitive Abilities Screening Instruments (CASI).Results: PSD was diagnosed in 21%. PSD was significantly associated with increasing age, low levels of education, large sized and lacunar infarctions, severity of stroke, prolonged P300 latency, smoking, hypertension, and elevated Hcy levels. High Hcy levels increased the odds ratio of PSD after adjustment of significantly relevant variables including age, smoking, size of infarction, and carotid stenosis.Conclusions: Cognitive decline is common after stroke. The results of this study indicate that PSD may result from stroke and its related risk factors including possible direct association with high Hcy levels. Better knowledge of the risk factors for PSD should increase the effectiveness of preventive strategies in patients with this condition.Keywords: post-stroke dementia, vascular risk factors, homocysteine Eman M KhedrSherifa A HamedHala K El-ShereefOla A ShawkyKhalid A Mohamedet alDove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2009, Iss default, Pp 103-116 (2009)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Eman M Khedr Sherifa A Hamed Hala K El-Shereef Ola A Shawky Khalid A Mohamed et al Cognitive impairment after cerebrovascular stroke: Relationship to vascular risk factors
description	Eman M Khedr1, Sherifa A Hamed1, Hala K El-Shereef2, Ola A Shawky1, Khalid A Mohamed1, Effat M Awad3, Mohamed A Ahmed2, Ghaydaa A Shehata1, Mahmoud A Eltahtawy41Department of Neurology and Psychiatry, 2Department of Internal Medicine, 3Department of Physiology, 4Department of Clinical Pathology, Assiut University, Faculty of Medicine, Assiut, EgyptBackground: Cognitive decline after cerebrovascular stroke has adverse outcome consequences. Since some vascular causes can be prevented and treated, the identification of stroke-related cognitive impairment is a challenge. Patients with cognitive impairment and vascular diseases exhibit higher homocysteine (Hcy) concentrations. Whether Hcy is an independent risk factor for cognitive impairment after stoke is still in question. The objectives of this study were to determine: 1) the relative frequency of first-ever post-stroke dementia (PSD) (three months after onset) in a consecutive sample of our population, 2) the risk factors associated with PSD, and 3) the relationship between Hcy levels and PSD.Methods: Eighty-one inpatients with first-ever stroke were prospectively evaluated with a neuropsychological battery and event-related evoked potentials (P300) at onset and then after three months. A wide range of demographic, clinical, radiological and laboratory variables were examined. PSD was diagnosed if the clinical presentation fulfilled DSM-IV criteria of vascular dementia, the patient scored &le;21 on Mini Mental State Examination (MMSE) and &le;67 points on Cognitive Abilities Screening Instruments (CASI).Results: PSD was diagnosed in 21%. PSD was significantly associated with increasing age, low levels of education, large sized and lacunar infarctions, severity of stroke, prolonged P300 latency, smoking, hypertension, and elevated Hcy levels. High Hcy levels increased the odds ratio of PSD after adjustment of significantly relevant variables including age, smoking, size of infarction, and carotid stenosis.Conclusions: Cognitive decline is common after stroke. The results of this study indicate that PSD may result from stroke and its related risk factors including possible direct association with high Hcy levels. Better knowledge of the risk factors for PSD should increase the effectiveness of preventive strategies in patients with this condition.Keywords: post-stroke dementia, vascular risk factors, homocysteine
format	article
author	Eman M Khedr Sherifa A Hamed Hala K El-Shereef Ola A Shawky Khalid A Mohamed et al
author_facet	Eman M Khedr Sherifa A Hamed Hala K El-Shereef Ola A Shawky Khalid A Mohamed et al
author_sort	Eman M Khedr
title	Cognitive impairment after cerebrovascular stroke: Relationship to vascular risk factors
title_short	Cognitive impairment after cerebrovascular stroke: Relationship to vascular risk factors
title_full	Cognitive impairment after cerebrovascular stroke: Relationship to vascular risk factors
title_fullStr	Cognitive impairment after cerebrovascular stroke: Relationship to vascular risk factors
title_full_unstemmed	Cognitive impairment after cerebrovascular stroke: Relationship to vascular risk factors
title_sort	cognitive impairment after cerebrovascular stroke: relationship to vascular risk factors
publisher	Dove Medical Press
publishDate	2009
url	https://doaj.org/article/ce8fd7fa396549c285cc588c055510c3
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_version_	1718401100524027904

Cognitive impairment after cerebrovascular stroke: Relationship to vascular risk factors

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