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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
07:30

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions

Published on: April 23, 2021

Cognitive impairment after cerebrovascular stroke: Relationship to vascular risk factors

Eman M Khedr1, Sherifa A Hamed, Hala K El-Shereef

  • 1Department of Neurology and Psychiatry, Assiut University Hospital, PO Box 71516, Assiut, Egypt.

Neuropsychiatric Disease and Treatment
|June 27, 2009
PubMed

Insights

Post-stroke dementia (PSD) affects 21% of patients and is linked to elevated homocysteine (Hcy) levels. Identifying risk factors like Hcy is crucial for preventing cognitive decline after stroke.

Area of Science:

  • Neurology
  • Neuroscience
  • Vascular Medicine

Background:

  • Cognitive decline following cerebrovascular stroke presents significant adverse outcomes.
  • Identifying stroke-related cognitive impairment is challenging, as some vascular causes are treatable.
  • Elevated homocysteine (Hcy) levels are observed in patients with cognitive impairment and vascular diseases, prompting investigation into its role.

Purpose of the Study:

  • To determine the frequency of first-ever post-stroke dementia (PSD) three months after stroke onset.
  • To identify risk factors associated with PSD.
  • To examine the relationship between homocysteine (Hcy) levels and PSD.

Main Methods:

  • Prospective evaluation of 81 first-ever stroke inpatients using neuropsychological tests and event-related evoked potentials (P300).
  • Assessment of demographic, clinical, radiological, and laboratory variables.
  • Diagnosis of PSD based on DSM-IV criteria for vascular dementia, Mini Mental State Examination (MMSE), and Cognitive Abilities Screening Instruments (CASI) scores.

Main Results:

  • Post-stroke dementia (PSD) was diagnosed in 21% of patients.
  • PSD was significantly associated with older age, lower education, stroke severity, infarction size/type, prolonged P300 latency, smoking, hypertension, and elevated Hcy levels.
  • High Hcy levels independently increased the odds ratio for PSD, even after adjusting for other significant variables.

Conclusions:

  • Cognitive decline is a common consequence of stroke.
  • Post-stroke dementia (PSD) is associated with stroke and its risk factors, including a potential direct link to elevated homocysteine (Hcy) levels.
  • Understanding PSD risk factors can enhance preventive strategies for affected patients.
Abstract

Keywords:
homocysteinepost-stroke dementiavascular risk factors

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