A Clinical Study On Cognitive Impairment In Ischemic Post-stroke Patients With Metabolic Syndrome

Objective To explore the cognitive status of ischemic post-stroke patients with metabolic syndrome(MetS)and to explore the involved cognitive domains and the development of the cognitive impairment.Methods Totally94consentive first-ever ischemic stroke patients in the ward of Department of Neurology.the fifth central hospital of Tianjin were collected during April2009to August2009and were divided into stroke without MetS group (54) and stroke with MetS group (40) according to the diagnostic criteria for MetS defined by Chinese Diabetes Society(CDS)in2004.All patients were administered to Mini-Mental State Examination(MMSE).Clock Drawing Task(CDT).animal Verbval Fluency Test(aVFT),Trial Making Test-A(TMT-A)in2weeks and at3months after stroke to evaluate mental state such as verbal learning memory.executive,attentional and visuospatial abilities..The incidence of cognitive impairment and its evolution were assessed in two group subjects.Results The totally incidence of cognitive impairment was24.47%in2weeks after stroke and22.34%at3months after stroke(among94case the incidence of no dementia was21.28%and19.15%,while the incidence of dementia was3.19%and3.19%). The incidence of cognitive impairment was higher in the stroke patients with MetS than the stroke patients without MetS.37.50%/VS14.81%(Z=2.500. P=0.012) in2weeks after stroke and35.00%vs12.96%(Z=2.513, p=0.012) at3months after stroke.The scores of MMSE. delay recall and CDT of the stroke patients with Mets and without MetS in2weeks after stroke and at3months after stroke were24.00(5.50)VS28.00’4.00),2.00(1.50) VS2.00(1.00).3.00(2.00) VS4.00(2.00)及25.00(7.25) VS28.00(4.00),2.00(2.50) VS2.00(1.00).2.50(1.25VS3.50(1.00).Scores of stroke patients with MetS were significantly lower than that of the stroke patients without MetS both in2weeks and at3month after stroke (2=2.541P=0.013, z=2.442P=0.018.z=2.312P=0.025及z=2.661P=0.009, z=2.422 P=0.019, z=2.515P=0.016).The stroke patients with Mets had more cognition deterioration than the stroke patients without MetS at3months after stroke, the difference was significient (Z=2.134P=0.003)Conclusions Cognitive deficits commonly exist in ischemic post-stroke patients with MetS.For the involved domains,executive dysfunction is the most common deficits of memory is also common. The stroke patients with Mets had more cognition deterioration after stroke.