The Predictive Value Of Short Cognitive Assessment Of Acute Stroke For Short-term Cognitive Function

Objectives Whether brief cognitive assessment of 3 weeks after ischemic stroke can predict the overall cognitive function and the functional status of each cognitive domain after 3~6 months of stroke.Methods The clinical data and imaging demographic data,vascular risk in 254 patients with acute ischemic stroke,prospective registry from August 2016 to December 2017 consecutive patients,including 161 cases of stroke in 3 weeks after the completion of the Mini Mental State Scale(MMSE)and Montreal cognitive assessment scale(Mo CA)assessment.After 3~6 months of stroke,a comprehensive cognitive function was evaluated,including memory,execution,language,attention,and speed of information processing.According to the cognitive domain damage number,divided into normal cognitive function / mild cognitive impairment group and moderate / severe cognitive impairment;cognitive domain damage in patients with stroke defined number of < 3 for the no / mild cognitive dysfunction,stroke patients defined cognitive domain number less than 3 damage for moderate / severe cognitive dysfunction.Statistical measurement data described by the mean and standard deviation(normal distribution)or median(non normal distribution)said,by analysis of variance(normal distribution)or Mann-Whitney U(non normal distribution)test was used for data analysis;count data using 2 test or Fisher exact probability method of multi factor analysis;Logistic regression was used to analyze independent risk factors of overall cognitive domain and 3~6 months in the cognitive,single factor analysis P < 0.2 variables into the regression equation,the results with the OR value and 95% confidence interval(95%CI),P < 0.05,the difference was statistically significant.Results A total of 254 patients with acute ischemic stroke were enrolled in a group.Excluded because of upper limb muscle strength is poor,18 cases could not be completed due to severe cognitive evaluation;with disorder of consciousness in 14 cases;because of severe aphasia or dysarthria and can not complete the full set of measurements in 12 cases;4 cases of cognitive impairment after stroke;previous / serious depression in 10 cases;the death or reject 35 the final follow-up patients;161 patients completed the short baseline cognitive assessment,including 138 cases of complete stroke in 3~6 months of cognitive evaluation.In the latter part of a comprehensive cognitive assessment process,70 cases of normal memory function,68 cases of abnormal memory;executive function in 75 cases of normal,63 cases of abnormal executive function;84 cases of normal language function,language dysfunction(54 cases and 1 cases did not complete the assessment);31 cases of normal function of attention,attention 107 cases of dysfunction;42 cases of normal speed of information processing,information processing disorders in 96 cases.1.Predictive value of baseline cognitive assessment for each cognitive domain in 3~6 months after stroke:logistic analysis showed that,the baseline cognitive state was independent of the memory/executiv/ language/information processing function of 3~6 months after stroke(P < 0.05).2.The predictive value of baseline cognitive assessment on the overall cognitive function of 3~6 months after stroke:according to the definition of how many impaired cognitive domain general cognitive function,the results showed that there was no / mild cognitive dysfunction group in 61 cases,including 24 cases of 5 cognitive domains were normal,15 cases of 1 cognitive domain abnormalities,22 cases of the 2 cognitive domains abnormal;moderate / severe cognitive dysfunction group in 77 cases,including 17 cases the 3 cognitive domains of abnormal cases,26 cases of 4 cognitive domain abnormalities,34 cases of 5 cognitive domains all abnormal.Univariate analysis showed that age,education level,baseline cognition status,triglyceride level after admission,location of infarction and Fazekas WML score were the influencing factors of total cognitive function in 3~6 months after stroke(P < 0.05).Multivariate analysis showed that after adjusting for age,education level and other factors,baseline cognition was independently associated with total cognitive function in 3~6 months after stroke(P < 0.05).Conclusions Short term cognitive assessment after stroke can predict the overall cognitive level at 3~6 months after stroke,and predict the cognitive function of memory,execution,language and information processing speed.