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Published on: December 16, 2022
Cognitive dysfunction in stroke survivors: a community-based prospective study from Kolkata, India
Sujata Das1, Neelanjana Paul, Avijit Hazra
1Department of Neurology, Bangur Institute of Neuroscience, Kolkata, India.
Summary
Cognitive decline is common in Indian stroke survivors. Post-stroke dementia was more prevalent than mild cognitive impairment, with older age and cortical atrophy as key risk factors.
Area of Science:
- Neurology
- Cognitive Science
- Public Health
Background:
- Cognitive dysfunction is a significant outcome for stroke survivors, yet its prevalence in India remains largely uncharacterized.
- Understanding post-stroke cognitive impairment is crucial for developing targeted interventions and improving patient outcomes.
Purpose of the Study:
- To determine the prevalence of post-stroke mild cognitive impairment (psMCI) and post-stroke dementia (psDem) in Indian stroke survivors.
- To investigate the annual progression rate of cognitive impairment to dementia and identify associated risk factors.
- To analyze the impact of psDem on mortality in stroke survivors.
Main Methods:
- A prospective study involving 281 community-based stroke survivors in Kolkata, India, assessed annually for three years.
- Utilized validated cognitive tools administered by trained personnel under neuropsychologist supervision.
- Employed survival analysis to assess mortality risk in patients with psDem.
Main Results:
- The period prevalence of psDem was 13.88% at baseline, with an average annual progression rate of 3.53%.
- psMCI prevalence was 6.05% at baseline, with 10.6% converting to psDem annually.
- Older age at first stroke and cortical atrophy were significantly associated with increased dementia risk. psDem increased mortality risk (HR, 2.65).
Conclusions:
- Post-stroke dementia is more prevalent than psMCI in this Indian cohort, potentially influenced by prestroke dementia inclusion.
- The annual progression rates from stroke to psDem and from psMCI to psDem are comparable.
- Older age at first stroke and cortical atrophy are significant risk factors for dementia in stroke survivors, highlighting the need for early detection and management.
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