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Post-stroke depression, executive dysfunction and functional outcome.
T Pohjasvaara1, M Leskelä, R Vataja
1Memory Research Unit, Department of Clinical Neuroscience, Helsinki University Central Hospital, Finland.
European Journal of Neurology
|May 3, 2002
Summary
Executive dysfunction is common after ischemic stroke, impacting daily activities and cognitive status. Early detection using executive measures may help identify patients at risk for dementia and disability.
Area of Science:
- Neurology
- Neuropsychology
- Geriatrics
Background:
- Early diagnosis of vascular cognitive impairment remains challenging.
- Executive control function is a potential basis for diagnosing vascular dementia.
Purpose of the Study:
- To examine the correlates of executive dysfunction in a well-defined ischemic stroke cohort.
- To identify factors associated with executive dysfunction post-stroke.
Main Methods:
- A cohort of 256 ischemic stroke patients (aged 55-85) underwent comprehensive neuropsychological and psychiatric examinations 3-4 months post-stroke.
- Activities of daily living (ADLs), cognitive status (MMSE), and depression (Beck Depression Scale) were assessed.
- Stroke location (anterior vs. posterior circulation) and DSM-III-R dementia criteria were evaluated.
Main Results:
- 40.6% of patients exhibited executive dysfunction.
- Executive dysfunction was associated with older age, lower education, greater dependency, poorer ADLs, worse MMSE scores, and anterior circulation strokes.
- Independent correlates included complex ADLs, MMSE score, and posterior circulation strokes.
Conclusions:
- Clinically significant executive dysfunction is frequent after ischemic stroke.
- Executive dysfunction is linked to functional abilities and overall cognition, but distinct from depression.
- Executive function assessment can identify patients at risk for post-stroke dementia and disability.