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Cognitive Impairment after Lacunar Stroke and the Risk of Recurrent Stroke and Death
- Source :
- Cerebrovasc Dis
- Publication Year :
- 2020
-
Abstract
- Introduction: Patients with poststroke cognitive impairment appear to be at higher risk of recurrent stroke and death. However, whether cognitive impairment after lacunar stroke is associated with recurrent stroke and death remains unclear. We assessed whether global or domain-specific cognitive impairment after lacunar stroke is associated with recurrent stroke and death. Methods: We considered patients from the Secondary Prevention of Small Subcortical Strokes (SPS3) trial with a baseline cognitive exam administered in English by certified SPS3 personnel, 14–180 days after qualifying lacunar stroke. We considered a baseline score of ≤86 on the Cognitive Assessment Screening Instrument to indicate global cognitive impairment, Results: The study included 1,528 participants with a median enrollment time of 62 days after qualifying stroke. During a mean follow-up of 3.9 years, 11.4% of participants had recurrent stroke and 8.2% died. In the fully adjusted models, memory impairment was independently associated with an increased risk of recurrent stroke (hazard ratio, 1.48; 95% confidence interval [95% CI]: 1.04–2.09) and death (hazard ratio, 1.87; 95% CI: 1.25–2.79). Global impairment (hazard ratio, 1.66; 95% CI: 1.06–2.59) and nonmemory impairment (hazard ratio, 1.74; 95% CI: 1.14–2.67) were associated with an increased risk of death. Discussion/Conclusion: After lacunar stroke, memory impairment was an independent predictor of recurrent stroke and death, while global and nonmemory impairment were associated with death. Cognitive screening in lacunar stroke may help identify populations at higher risk of recurrent stroke and death.
- Subjects :
- Male
medicine.medical_specialty
Lacunar stroke
Time Factors
Neuropsychological Tests
Risk Assessment
Article
Cognition
Memory
Predictive Value of Tests
Recurrence
Risk Factors
Internal medicine
Cause of Death
Medicine
Memory impairment
Humans
Cognitive Dysfunction
cardiovascular diseases
Stroke
Aged
Randomized Controlled Trials as Topic
Memory Disorders
business.industry
Proportional hazards model
Hazard ratio
Middle Aged
medicine.disease
Prognosis
Cognitive test
Neurology
Stroke, Lacunar
Female
Neurology (clinical)
Cardiology and Cardiovascular Medicine
business
Cohort study
Subjects
Details
- ISSN :
- 14219786
- Volume :
- 50
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Cerebrovascular diseases (Basel, Switzerland)
- Accession number :
- edsair.doi.dedup.....1387c68c6dc343d7e3abfacd8e0028c9