Cognitive syndromes after the first stroke

Neurol Sci. 2018 Aug;39(8):1445-1451. doi: 10.1007/s10072-018-3447-6. Epub 2018 May 19.

Abstract

Aim: The aim of this study is to determine impairments of certain cognitive functions in certain vascular cognitive syndromes and to identify predictors of dementia.

Patients and methods: One-year prospective study included 275 patients, who were hospitalized at the Department of Neurology Tuzla and therefore fulfilled certain criteria. Patients were divided into following subgroups of vascular cognitive impairment (VCI): dementia of strategic infarct (DSI), cortical dementia (CD), sub cortical dementia (SCD), hemorrhagic dementia (HD), and patients without dementia. Each of the patients underwent the clinical examination and scoring with appropriate measurement scales.

Results: Some of the types of VCI were verified in 190 (69%) patients, and the most common was SCD (58%). There was statistically significant connection between the level of intelligence and occurrence of VCI in patients after stroke (p < 0.001). We found significant connection between occurrence of dementia and impairment in narrative memory, numerical memory, visual perceptive, and visual constructive functions in patients with dementia compared with non-demented (p = 0.0001). The executive functions were statistically impaired in patients with CD (p = 0.004) and SCD (p < 0.001). Patients without dementia have significantly better quality of life than the demented ones (p < 0.0001). The algorithm "tree of decision" can help us in the prediction of dementia based on the impairment of certain cognitive functions.

Conclusion: Vascular cognitive syndromes are common after stroke. Some of the cognitive functions are significantly impaired in patients with dementia. Impairment of the certain cognitive functions can help in predicting the onset of dementia. Patients without dementia have better quality of life.

Keywords: Cognitive functions; Dementia; Vascular cognitive syndrome.

MeSH terms

  • Aged
  • Cognition Disorders / diagnosis
  • Cognition Disorders / etiology*
  • Cognition Disorders / psychology
  • Dementia / diagnosis
  • Dementia / etiology*
  • Dementia / psychology
  • Executive Function
  • Female
  • Humans
  • Male
  • Neuropsychological Tests
  • Quality of Life
  • Retrospective Studies
  • Severity of Illness Index
  • Stroke / complications*