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Cognitive impairment after stroke: frequency, patterns, and relationship to functional abilities

T K Tatemichi1, D W Desmond, Y Stern

  • 1Department of Neurology, Columbia University, College of Physicians and Surgeons, New York, NY.

Journal of Neurology, Neurosurgery, and Psychiatry
|February 1, 1994
PubMed
Summary

Cognitive impairment is common after ischemic stroke, affecting memory, language, and attention. This impairment significantly increases the risk of dependent living, independent of physical disability.

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Area of Science:

  • Neurology
  • Neuropsychology
  • Rehabilitation Medicine

Background:

  • Ischemic stroke frequently leads to cognitive deficits.
  • Understanding the prevalence and impact of post-stroke cognitive impairment is crucial for patient outcomes.

Purpose of the Study:

  • To assess cognitive function in patients three months after ischemic stroke.
  • To determine the association between cognitive impairment and functional outcomes post-stroke.

Main Methods:

  • Evaluated 227 ischemic stroke patients and 240 controls using 17 cognitive tests.
  • Defined cognitive impairment as failure on four or more items, adjusting for demographic factors.
  • Utilized logistic regression to analyze the impact of cognitive impairment on dependent living.

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Main Results:

  • 35.2% of stroke patients exhibited cognitive impairment compared to 3.8% of controls.
  • Memory, orientation, language, and attention were the most affected cognitive domains.
  • Cognitive impairment was independently associated with a 2.4-fold increased risk of dependent living post-stroke.

Conclusions:

  • Cognitive impairment is a frequent and significant consequence of ischemic stroke.
  • Cognitive deficits substantially impact functional independence after stroke, irrespective of physical impairment.
  • Future stroke outcome studies and interventions must consider both cognitive and physical deficits.