• Guri Hagberg, Brynjar Fure, Bente Thommessen, Håkon Ihle-Hansen, Anne-Rita Øksengård, Ståle Nygård, Sarah T Pendlebury, Mona K Beyer, Torgeir Bruun Wyller, and Hege Ihle-Hansen.
• Department of Internal Medicine, Bærum Hospital, Vestre Viken Hospital Trust, Oslo, Norway, guri.hagberg@gmail.com.
• Dement Geriatr Cogn Disord. 2019 Jan 1; 48 (1-2): 45-55.

Background And PurposeKnowledge of the burden and development of post-stroke cognitive impairments (CIs) in the long-term after the first event is limited. We aimed to assess the prevalence of mild CI (MCI) and dementia 7 years after first-ever stroke or transient ischemic attack (TIA), to subclassify the impairments, and to identify predictors for a favorable cognitive outcome.Materials And MethodsDuring 2007 and 2008, 208 patients with first-ever stroke or TIA without preexisting CI were included. After 1 and 7 years, survivors were invited to a follow-up. Transitions of cognitive status from 1 to 7 years were recorded based on the 3 categories dementia, MCI, or none. Etiologic subclassification was based on clinical cognitive profile, magnetic resonance imaging (MRI) findings, and biomarkers at both time points. Favorable outcome was defined as normal cognitive function or MCI after 7 years with exclusion of those who had progression from normal to MCI.ResultsEighty patients died during follow-up, 12 patients refused further participation. After 7 years, 109 completed follow-up of whom 40 (37%) were diagnosed with MCI and 24 (22%) with dementia. Of the 64 patients diagnosed with CI, 9 were subclassified with degenerative cognitive disease, 13 with vascular disease, and 42 had mixed cognitive disease. In all, 65 patients (60%) had a favorable outcome. In multivariable logistic regression analysis, lower age and lower medial temporal lobe atrophy (MTLA) grade on MRI at 12 months were independently associated with a favorable outcome, adjusted OR (95% CI), 0.94 (0.86-0.92), and 0.55 (0.35-0.85), respectively.ConclusionsSixty percent of stroke survivors have a favorable cognitive outcome. Lower age and lower MTLA grade on MRI were associated with favorable outcome.© 2019 S. Karger AG, Basel.

32 keywords...

hide…