Factors associated with improvement or decline in cognitive function after an ischemic stroke in Korea: the Korean stroke cohort for functioning and rehabilitation (KOSCO) study

被引：13

作者：

Yoon, Jin A. ^{[1
]}

Kim, Deog Young ^{[2
]}

Sohn, Min Kyun ^{[3
]}

Lee, Jongmin ^{[4
]}

Lee, Sam-Gyu ^{[5
]}

Lee, Yang-Soo ^{[6
]}

Han, Eun Young ^{[7
]}

Joo, Min Cheol ^{[8
]}

Oh, Gyung-Jae ^{[8
]}

Han, Junhee ^{[9
]}

Park, Minsu ^{[1
]}

Park, Kyung Pil ^{[10
]}

Noh, Kyung-Ha ^{[10
]}

Chang, Won Hyuk ^{[11
]}

Shin, Yong-Il ^{[1
,12
]}

Kim, Yun-Hee ^{[11
]}

机构：

[1] Pusan Natl Univ, Sch Med, Dept Rehabil Med, Res Inst Convergence Biomed Sci & Technol, 20 Geumo Ro, Yangsan 626770, South Korea

[2] Yonsei Univ, Coll Med, Dept & Res Inst Rehabil Med, 50-1 Yonsei Ro, Seoul 120752, South Korea

[3] Chungnam Natl Univ, Sch Med, Dept Rehabil Med, 282 Munhwa Ro, Daejeon 301721, South Korea

[4] Konkuk Univ, Sch Med, Dept Rehabil Med, 120-1 Neungdong Ro, Seoul 143729, South Korea

[5] Chonnam Natl Univ, Sch Med, Dept Phys Med & Rehabil, 42 Jebong Ro, Gwangju 501757, South Korea

[6] Kyungpook Natl Univ, Coll Med, Dept Rehabil Med, 130 Dongdeok Ro, Daegu 700721, South Korea

[7] Univ Jeju, Coll Med, Jeju Univ Hosp, Dept Rehabil Med, 15 Aran 13 Gil, Jeju 690767, South Korea

[8] Wonkwang Univ, Dept Rehabil Med, Sch Med, 895 Muwang Ro, Iksan 570711, Jeonlabuk Do, South Korea

[9] Pusan Natl Univ, Yangsan Hosp, Res & Stat Support, Res Inst Convergence Biomed Sci & Technol, 20 Geumo Ro, Yangsan 626770, South Korea

[10] Pusan Natl Univ, Yangsan Hosp, Dept Neurol, Coll Med, 20 Geumo Ro, Yangsan 626770, South Korea

[11] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Heart Vasc & Stroke Inst,Ctr Prevent & Rehabil,De, 50 Ilwon Dong, Seoul 135710, South Korea

[12] Pusan Natl Univ, Dept Rehabil Med, Sch Med, Res Inst Convergence Biomed Sci & Technol,Yangsan, 20 Geumo Ro, Yangsan 626770, South Korea

来源：

BMC NEUROLOGY | 2017年 / 17卷

关键词：

Ischemic stroke; Cognition; Inverter; Reverter; Risk factors; BASE-LINE FREQUENCY; MINI-MENTAL-STATE; POSTSTROKE DEMENTIA; CLINICAL DETERMINANTS; RELIABILITY; SURVIVORS; EPIDEMIOLOGY; IMPAIRMENT; PREVALENCE; VALIDATION;

D O I：

10.1186/s12883-016-0780-3

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background: We conducted a prospective cohort study to investigate prevalence of poststroke cognitive impairment at 3 and 12 months after stroke onset and identify clinical and demographic factors associated with improvement or decline in cognitive function between 3 months and 12 months. Methods: We analyzed the cognitive assessments of total patients and patients older than 65 years separately. All patients with an ischemic stroke were divided into normal cognitive group (NCG) and impaired cognition group (ICG) by using a cutoff score on the Korean Mini-Mental State Examination (K-MMSE). Patients were additionally classified into 3 subgroups according to the changes in their K-MMSE scores between 3 and 12 months: Stable group with K-MMSE scores changes ranging from -2 to +2 points (-2 <= Delta MMSE <= +2); converter group with increase more than 3 points (3 <= Delta MMSE); and reverter group with decrease more than 3 points (-3 <= Delta MMSE). We also analyzed factors affecting cognitive change from 3 months to 12 months among the 3 groups including baseline medical record, stroke and treatment characteristics, and various functional assessments after 3 months. Results: This study included 2,625 patients with the first time ischemic stroke. Among these patients, 1,735 (66.1%) were classified as NCG, while 890 patients (33.9%) were belonged to the ICG at 3 month. Within the NCG, 1,460 patients (82.4%) were stable group, 93 patients (5.4%) were converter group, and 212 patients (12.2%) were reverter group at 12 months onset. Within the ICG group, 472 patients (53.0%) were stable group, 321 patients (36.1%) were converter group, and 97 patients (10.9%) were reverter group. When different factors were investigated, the three subgroups in NCG and ICG showed significant different factors affecting cognitive function from 3 to 12 month. Conclusions: The prevalence of cognitive impairment showed difference between 3,12 months. To analyze the cognitive change from 3 month to 12 month, the proportion stable group was dominant in NCG and converter group was higher in ICG. By investigating the influencing factors from each group, we were able to identify the predictors including the age factor.

引用

页数：12

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