Cognitive function in stroke survivors: A 10-year follow-up study

Area of Science:

• Neurology
• Cognitive Science
• Public Health

Background:

• Post-stroke cognitive impairment (PSCI) significantly impacts patients and society.
• Long-term studies on PSCI are limited, potentially due to assessment methods and selection bias.

Purpose of the Study:

• To assess the prevalence of long-term PSCI in stroke survivors.
• To compare the effectiveness of the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) in identifying PSCI.
• To compare the cognitive function of long-term stroke survivors with non-stroke individuals.

Main Methods:

• 10-year stroke survivors from the Lund Stroke Register (2001-2002) underwent MMSE and MoCA assessments.
• PSCI was defined by MMSE scores <27 and/or MoCA scores <25; severe impairment by MMSE <23.
• Stroke survivors were compared to age- and sex-matched non-stroke controls from the 'Good Ageing in Skåne' study using logistic regression.

Main Results:

• Among 127 ten-year stroke survivors, PSCI prevalence was 46% (MMSE) and 61% (MoCA).
• 35% of survivors with MoCA <25 had MMSE ≥27, indicating MoCA detected more cases.
• Stroke survivors had significantly higher odds of severe cognitive impairment (MMSE <23) compared to controls (OR=2.5, P=.004).

Conclusions:

• Long-term PSCI is prevalent in stroke survivors, with increased odds of severe impairment compared to the general population.
• The Montreal Cognitive Assessment (MoCA) appears more sensitive than the Mini-Mental State Examination (MMSE) for detecting long-term PSCI.
• Previous estimates of long-term PSCI burden may be underestimated.