The Study Of Loewenstein Occupational Therapy Cognitive Assessment On Cognitive Impairment In Patients Of Single Intracerebral Hemorrhage

Objective:Application of LOTCA scale to investigate the characteristics of early cognitive impairment in patients with single intracerebral hemorrhage, analyze the relationship among in cognitive impairment, depression, anxiety.And to investigate correlation factor of the early cognitive impairment in patient with intracerebral hemorrhage.Methods:The exclusion criteria and the inclusion criteria for intracerebral hemorrhage group and control group were defined, from february2013to march2014in the First Affiliated Hospital of Kunming Medical University, neurological department of internal medicine treatment of intracerebral hemorrhage in patients with cerebral hemorrhage of48cases as case group, with cerebral hemorrhage patients age healthy population, gender, education level matched patients’ families, nursing staff, medical personnel and others of50cases as healthy control group. All the patients were evaluated with half of month after the onset of the illness.The Loewenstein Occupational Therapy Cognitive Assessment Battery(LOTCA)(Second Edition) was used to evaluate the cognitive function from the orientation, visual perception, spatial perception, motor praxis, visumotor organization and thinking operation and calculated each object of study scores.Analysis of the two groups was whether different. According to the age, education level, the relevant factors to intracerebral hemorrhage were grouped evaluation, analysis of the correlation between these factors and the scores of scale.And Self-Rating Depression Scale(SDS),Self-Rating Anxiety Scale(SAS) were used to evaluate depression, anxiety. Results:1.Comparing the results of cognition function of intracerebral hemorrhage group and control group:In the totle score of cognitive function, the score of each item and the score of every item, the patients of intracerebral hemorrhage have lower compared with the control, and the difference was statistically significant (P<0.05);2.The correlation analyzing among the total score of cognitive function, the level score of SDS and SAS in patients with intracerebral hemorrhage:①This correlation was observed of the total score of cognitive function both in the level score of SDS and the level score of SAS (r=-0.320, r=-0.481, P＜0.05),②There were correlation between the orientation, visual perception, spatial perception, motor praxis, visumotor organization and thinking operation score of LOTCA and the level score of SDS and also the level score of SAS. the one r values range from0.190to0.390, the other from0.110to0.481.3.The intracerebral hemorrhage patients with post-stroke depression and anxiety have lower total score of cognitive function compared with the patients without post-stroke depression and anxiety,and the difference between them are statistically significant (P＜0.05).4.The patients of intracerebral hemorrhage have lower score in older, smoking, drinking, hypertension, hyperglycemia, dyslipidemia, when the incidence of size in focus of intracerebral hemorrhage, breaking into ventricle enlargement compared with the control(P<0.05);But gender and in different side intracerebral hemorrhage, no differences were found in LOTCA total score between the patients of intracerebral hemorrhage group and the control group (P>0.05). But further multiple regression analysis showed that the values of patients with delirium or irritability, older age, lower education level, hypertension,in different hemispheres hemorrhage are very small (P＜0.05), the five factors can enter to the equations have effection.Conclusion:1.There is an extent degree early cognitive function impairment in patient with acute intracerebral hemorrhage, which displays general damage of orientation, visual perception, spatial perception, motor praxis, visumotor organization and thinking operation.2.The depression and anxiety impact early cognitive function in patients with acute intracerebral hemorrhage.3.delirium or irritability,older-age,lower education level, hypertension,in different hemispheres hemorrhage may greatly affect cognitive impairment in patients with cerebral hemorrhage.