The Influence of Demographic, Clinical, Psychological and Functional Determinants on Post-stroke Cognitive Impairment at Day Care Stroke Center, Malaysia

Background: This study aims to estimate the prevalence and explore the predictors for post-stroke cognitive impairment at the community level in Malaysia. Methods: A total of 50 stroke patients aged 29 to 81-year-old were included in this study. A face to face interview was conducted to gather the demographic and clinical data. Subsequently, assessments including Barthel ADL Index (BI), Addenbrooke's Cognitive Examination-Revised (ACE-R) and Hospital Anxiety and Depression Scale (HADS) were administered to the subjects. Results: The results showed that the prevalence of cognitive impairment was 76% among the studied populations. The subjects' race (Fisher's value=9.56, P < 0.05) and education level (Fisher's value = 7.29, P < 0.05) were significantly associated with the cognitive status. The depression score was significantly higher in cognitively impaired group [t (48) = -4.42, P < 0.001] while the Barthel Index score was significantly lower in cognitively impaired group (median = 18.00, P < 0.05). The univariate logistic analysis demonstrated that Chinese (OR 7.33, 95% CI = 1.61-33.51), lower education level (OR 9.33, 95% CI = 0.89-97.62), right sided lesion (OR 0.29, 95% CI = 0.06-1.54), left face weaknesses (OR 0.40, 95% CI 0.09-1.83), high cholesterol (OR 0.45, 95% CI = 0.12-1.75), depression (OR 2.16, 95% CI = 0.85-1.35), and Barthel Index (OR 0.79, 95% CI = 0.57-1.10) were significant predictors. Finally, multivariate logistic regression verified that depression was the only significant predictor of post-stroke cognitive impairment (OR 2.03, 95% CI = 1.20-3.45). Conclusion: In conclusion, the prevalence of cognitive impairment in this study was higher than other community based studies and depression was a risk factor for cognitive impairment.