Cognitive impairment one year after ischemic stroke: predictorsand dynamics of significant determinants

Authors: MARGARITA LUBOMIROVA ALEXANDROVA, MAYA PENKOVA DANOVSKA

Abstract: Background/aim: Evidence suggests that the risk for dementia increases after stroke. This study investigated the dynamics of the neurological and cognitive status of patients with no baseline dementia over a 1-year period after ischemic stroke. Materials and methods: We examined 47 ischemic stroke patients admitted within 48 h of ictus. Their neurological and cognitive statuses, blood biochemical parameters, and microalbuminuria levels were prospectively evaluated over a 1-year period post-stroke. Results: A more severe neurological deficit was found in the cognitively impaired patients (P = 0.003). The NIHSS score over a 1-year follow-up period improved only in patients with normal cognition (P = 0.000). Time-varying dynamics of the MMSE score were observed in both patient groups (P = 0.000). Age (P = 0.000), education (P = 0.004), sex (P = 0.041), history of diabetes (P = 0.045), and serum high sensitive C-reactive protein (hs-CRP) on admission (P = 0.003) were significant determinants of cognitive decline 1 year after a stroke. The albumin-to-creatinine ratio was high during the whole follow-up period in the cognitively impaired group after adjusting for sex and age (P = 0.010). Binary logistic regression showed that hs-CRP (P = 0.013) and age (P = 0.010) were independent predictors of patients' cognitive status 1 year after stroke. Conclusion: The level of inflammatory markers could be considered as an additional criterion of long-term cognitive impairment.

Keywords: Cognitive impairment, hs-CRP, ischemic stroke, long-term prognosis, endothelial dysfunction

Full Text: PDF