Subcortical features and cognitive performance in Hungarian cerebrovascular outpatients

Cerebrovascular diseases are common in Central and East Europe, and the resulting cognitive impairment is probably also frequent. Although this problem attracted a lot of attention in the last decade, systematic examination of cognitive functions is not routinely performed in cerebrovascular patients. In our study involving cerebrovascular outpatients, we used the MMSE and the Barthel Index combined with a checklist for the evaluation of subcortical features. From a total of 176 cases, 32% had at least one subcortical sign. Except for gait disturbance and unprovoked falls, patients with subcortical dysfunction had lower performances on MMSE and lower Barthel scores. Their mean age did not differ significantly from the age of patients without subcortical signs, except for the subgroups with urinary and gait disturbances. Cognitive deficit could be detected in 27 patients, nine of them fulfilled the criteria for dementia. Subcortical signs and cognitive impairment can also be present in apparently well-being cerebrovascular patients. The routine evaluation of these deficiencies must be an integral part of the management of cerebrovascular patients and in planning their complex rehabilitation. Short, widely usable and easily executable tests are recommended.