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Early Cognitive Impairment at Acute Stage After Intracerebral Hemorrhage

Yaqian Huang1, Cong Gu2, Wei Zhang1,3

  • 1Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China.

Current Neurovascular Research
|November 8, 2022
PubMed

Insights

Nearly half of patients experience cognitive impairment after acute intracerebral hemorrhage (ICH). Early, low Montreal Cognitive Assessment (MoCA) scores predict later cognitive decline, highlighting the need for timely intervention.

Area of Science:

  • Neurology
  • Neuroscience
  • Public Health

Background:

  • Cognitive impairment is a frequent complication following acute intracerebral hemorrhage (ICH).
  • Evidence regarding early cognitive impairment in the acute phase of ICH is limited.
  • This study investigated the frequency, risk factors, and outcomes of early cognitive impairment post-ICH.

Purpose of the Study:

  • To determine the prevalence of early cognitive impairment at the acute stage after ICH.
  • To identify risk factors associated with acute cognitive impairment.
  • To examine the association between acute and delayed cognitive impairment.

Main Methods:

  • 208 patients with acute ICH were enrolled between January 2017 and February 2019.
  • Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) score during the acute phase (within 1 week) and at follow-up.
  • Significant cognitive impairment was defined as a MoCA score <20.

Main Results:

  • 89 (42.8%) patients had acute cognitive impairment, and 86 (46.5%) had delayed impairment over a mean 20-month follow-up.
  • Older age, larger hematoma volume, severe ICH, and lower education were linked to acute cognitive impairment (P ≤ 0.009).
  • A low MoCA score during the acute stage independently predicted delayed significant cognitive impairment (OR 0.59; 95% CI 0.48-0.71; P<0.001).

Conclusions:

  • Significant cognitive impairment affects nearly half of patients in the acute phase after ICH.
  • Risk factors include advanced age, large hematoma volume, and severe initial neurological deficits.
  • Low acute-phase MoCA scores are an independent predictor of subsequent cognitive impairment.
Abstract

Keywords:
Intracerebral hemorrhageMontreal Cognitive Assessment (MoCA)acute stagecognitive impairmentischemic stroke.premature mortality

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