Predictors for Favorable Cognitive Outcome Post-Stroke: A-Seven-Year Follow-Up Study.
BACKGROUND AND PURPOSE
Knowledge of the burden and development of post-stroke cognitive impairments (CIs) in the long-term after the first event is limited. We aimed to assess the prevalence of mild CI (MCI) and dementia 7 years after first-ever stroke or transient ischemic attack (TIA), to subclassify the impairments, and to identify predictors for a favorable cognitive outcome.


MATERIALS AND METHODS
During 2007 and 2008, 208 patients with first-ever stroke or TIA without preexisting CI were included. After 1 and 7 years, survivors were invited to a follow-up. Transitions of cognitive status from 1 to 7 years were recorded based on the 3 categories dementia, MCI, or none. Etiologic subclassification was based on clinical cognitive profile, magnetic resonance imaging (MRI) findings, and biomarkers at both time points. Favorable outcome was defined as normal cognitive function or MCI after 7 years with exclusion of those who had progression from normal to MCI.


RESULTS
Eighty patients died during follow-up, 12 patients refused further participation. After 7 years, 109 completed follow-up of whom 40 (37%) were diagnosed with MCI and 24 (22%) with dementia. Of the 64 patients diagnosed with CI, 9 were subclassified with degenerative cognitive disease, 13 with vascular disease, and 42 had mixed cognitive disease. In all, 65 patients (60%) had a favorable outcome. In multivariable logistic regression analysis, lower age and lower medial temporal lobe atrophy (MTLA) grade on MRI at 12 months were independently associated with a favorable outcome, adjusted OR (95% CI), 0.94 (0.86-0.92), and 0.55 (0.35-0.85), respectively.


CONCLUSIONS
Sixty percent of stroke survivors have a favorable cognitive outcome. Lower age and lower MTLA grade on MRI were associated with favorable outcome.
['Hagberg|Guri|G|', 'Fure|Brynjar|B|', 'Thommessen|Bente|B|', 'Ihle-Hansen|Håkon|H|', 'Øksengård|Anne-Rita|AR|', 'Nygård|Ståle|S|', 'Pendlebury|Sarah T|ST|', 'Beyer|Mona K|MK|', 'Wyller|Torgeir Bruun|TB|', 'Ihle-Hansen|Hege|H|']
D000368:Aged D001284:Atrophy D003071:Cognition D060825:Cognitive Dysfunction D003704:Dementia D018450:Disease Progression D005260:Female D005500:Follow-Up Studies D006801:Humans D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D009664:Norway D011237:Predictive Value of Tests D011379:Prognosis D020521:Stroke D013702:Temporal Lobe
Cognitive impairment Stroke Post-stroke dementia Prognosis