Frequency and predictors of post-stroke cognitive impairment in Ethiopian stroke survivors: A cross-sectional study

Background: Stroke is emerging as a public health threat to sub-Saharan African countries. Even though cognitive impairment is increasingly being recognized as a major cause of disability in stroke survivors there is no data on the burden of stroke related cognitive dysfunction from Ethiopia. In this study, we aimed to assess the frequency and predictors of post-stroke cognitive impairment in Ethiopian stroke survivors.Methods: Participants were adult stroke survivors who came for follow-up at least 3 months after the last stoke. Demographic and clinical data were collected using a structured questionnaire. We employed the Montreal Cognitive Assessment Scale-Basic (MOCA-B), modified Rankin Scale (mRS) and Patient Health Questionnaire-9 (PHQ-9) to assess post-stroke cognition, functional recovery, and depression, respectively.Results: Among 67 stroke survivors (mean age: 52.1 ± 12.7 years, females: 40.3%, low or no education: 41.8%, median stroke duration: 3 years), 28 (41.8%) had post-stroke cognitive impairment. Of these, 20 (30%) had mild cognitive impairment and 8 (12%) had post-stroke dementia. On multivariate analysis, increased age [AOR=0.24, 95% CI (0.07,0.83)], lower education [AOR=4.02, 95% CI (1.13,14.32)] and poor function recovery (mRS ³3) [AOR=0.27, 95% CI (0.08-0.81)] were independently associated with post-stroke cognitive impairment.Conclusion:Cognitive impairment is frequent among Ethiopian stroke survivors. We found that increased age, low educational attainment, and poor recovery on physical function were independently associated with cognitive decline. Although causality cannot be inferred, physical rehabilitation and better education might play a significant role in building cognitive resilience among stroke survivors.