Analysis Of Related Factors Of Memory And Learning Ability In Patients With Ischemic Stroke

Objective: Stroke survivors are increasing as ageing population and advances in medical technology.Cognitive impairments,including memory impairment,have seriously affected the quality of life of patients.However,little is known about the determinants of memory and learning function in the acute stage of ischemic stroke.The aim of this study was to explore the relationships between memory and learning abilities on the Auditory Verbal Learning Test(AVLT)following acute ischemic stroke and key clinical variables,so as to provide clinicians with the best treatment options and rehabilitation strategies to achieve better clinical outcomes for stroke patients.Methods: The subjects of this study were 220 patients with acute ischemic stroke who were hospitalized consecutively from October 2015 to August 2018.According to the inclusion and exclusion criteria,163 patients were included in this cross-sectional,exploratory study finally.All patients were tested with Mini-mental state examination(MMSE),Montreal cognitive assessement(Mo CA)and the Auditory Verbal Learning Test-Huashan(AVLT-H)when the condition was stable within three weeks after admission.The patients were divided into the memory impairment group and normal group according to the performance of immediate recall,long-delayed recall and recognition.Demographics,vascular risk factors,and other stroke data were collected.The detection rate was counted,and factors with statistically significant differences(P≤0.1)in the univariate analysis were incorporated into the multivariate analysis model to explore the independent risk factors affecting immediate recall,long-delayed recall and recognition.Results: The prevalence of immediate recall and long-delayed recall impairments were 41.1%(67/163)and 52.8%(86/163),respectively.Recognition disturbance was presented in 32.5%(53/163).In the univariate analysis,gender(Exp(B)=1.763,P=0.088),age(Exp(B)=1.048,P=0.005),education level(Exp(B)=0.900,P=0.016),infarct side(Exp(B)=1.805,P=0.083),and WMLs scores(Exp(B)=2.002,P=0.048)were influencing factors of immediate recall;age(Exp(B)=1.039,P=0.016),education level(Exp(B)=0.880,P=0.004),hypertension(Exp(B)=0.418,P=0.026),infarct side(Exp(B)=2.588,P=0.005)and infarct size(Exp(B)=3.612,P=0.006)were influencing factors of long-delay recall;age(Exp(B)=1.055,P=0.003),BMI(Exp(B)=0.898,P=0.058),hypertension(Exp(B)=0.340,P=0.026),first-ever stroke(Exp(B)=1.913,P=0.059),infarct side(Exp(B)=2.321,P=0.019),and WMLs scores(Exp(B)=2.120,P=0.037)were influencing factors of recognition.In the multivariate analysis,older age(Exp(B)=1.042,P=0.023),lower educational level(Exp(B)=0.911,P=0.050),and left hemispheric lesions(Exp(B)=8.103,P=0.004)were risk factors of immediate recall impairment;older age(Exp(B)=1.044,P=0.017),lower educational level(Exp(B)=0.888,P=0.014),left hemispheric lesions(Exp(B)=2.899,P=0.005),and small or medium size infarction(Exp(B)=5.010,P=0.002)were risk factors of long-delayed recall impairment;older age(Exp(B)=1.043,P=0.036)and left hemispheric lesions(Exp(B)=2.310,P=0.031)were risk factors of recognition impairment.After adjusted to age,educational level and size of stroke,the left hemispheric lesions were related independently to the immediate recall,the long-delayed recall,and the recognition.Conclusion: Memory and learning deficits are common in the acute stage of ischemic stroke.Age,educational level and left hemisphere lesions as the most important factors affecting memory and learning function after stroke.Our study may be of great help for the early treatment and recovery of ischemic stroke patients.