Cognitive impairment six months after ischaemic stroke: a profile from the ASPIRE-S study.
Cognitive impairment six months after ischaemic stroke: a profile from the ASPIRE-S study.
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DOI：
10.1186/s12883-015-0288-2
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发表时间：
2015-03-12
期刊：
影响因子：
2.6
通讯作者：
ASPIRE-S study group
中科院分区：
文献类型：
--
作者：
Mellon L;Brewer L;Hall P;Horgan F;Williams D;Hickey A;ASPIRE-S study group
认知障碍通常发生在中风后的急性期，但可能会持续，超过一半的中风幸存者经历某种形式的长期认知障碍。最近的证据表明，优化二级预防的坚持是预防中风复发以及中风相关认知障碍和痴呆症发生率的关键因素。本研究的目的是描述卒中幸存者在6个月时的认知损害情况，并确定与卒中后认知损害相关的因素，重点是适当的二级预防和心理功能指标。参与者在缺血性中风后6个月进行评估，这是中风二级预防干预和康复行动研究(ASPIRE-S)的一部分，该研究调查了社区中风后患者的二级预防和康复概况。认知障碍的测量使用蒙特利尔认知评估(MoCA)。256名中风患者在6个月时进行了评估。超过半数(56.6%)的受试者存在认知功能障碍，且认知功能障碍与女性(优势比 = 为1.6，95%可信区间为1.01~2.57)和脑血管病史(OR = 为2.22，95%可信区间为1.38~3.59)显著相关。抗高血压药物治疗(OR = .65，95%CI.44-.96)和抗凝治疗处方(OR = .41，95%CI.26-.68)与认知损害的可能性降低相关，然而，处方药物总数的增加与较差的认知损害中度相关(OR = 1.12，95%CI 1.04-1.19)。研究结果显示，中风后6个月的认知障碍水平令人担忧。令人鼓舞的是，确定了二级预防的方面，这些方面可能在减少中风后认知障碍的发生率方面具有保护作用。卒中后神经心理康复也是卒中康复模型的一部分，以应对卒中后认知障碍的负担。
Cognitive impairment commonly occurs in the acute phase post-stroke, but may persist with over half of all stroke survivors experiencing some form of long-term cognitive deficit. Recent evidence suggests that optimising secondary prevention adherence is a critical factor in preventing recurrent stroke and the incidence of stroke-related cognitive impairment and dementia. The aim of this study was to profile cognitive impairment of stroke survivors at six months, and to identify factors associated with cognitive impairment post-stroke, focusing on indicators of adequate secondary prevention and psychological function. Participants were assessed at six months following an ischaemic stroke as part of the Action on Secondary Prevention Interventions and Rehabilitation in Stroke study (ASPIRE-S), which examined the secondary preventive and rehabilitative profile of patients in the community post-stroke. Cognitive impairment was measured using the Montreal Cognitive Assessment (MoCA). Two-hundred and fifty-six stroke patients were assessed at six months. Over half of the sample (56.6%) were found to have cognitive impairment, with significant associations between cognitive impairment and female sex (odds ratio (OR) = 1.6, 95% CI 1.01-2.57) and history of cerebrovascular disease (OR = 2.22, 95% CI 1.38-3.59). Treatment with antihypertensive medications (OR = .65, 95% CI .44-.96) and prescription of anticoagulant therapy (OR = .41, 95% CI .26-.68) were associated with reduced likelihood of cognitive impairment, however increasing number of total prescribed medications was moderately associated with poorer cognitive impairment (OR = 1.12, 95% CI 1.04-1.19). Findings reveal levels of cognitive impairment at 6 months post-stroke that are concerning. Encouragingly, aspects of secondary prevention were identified that may be protective in reducing the incidence of cognitive impairment post-stroke. Neuropsychological rehabilitation post-stroke is also required as part of stroke rehabilitation models to meet the burden of post-stroke cognitive impairment.
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影响因子：
8.3
作者：
Douiri, Abdel;Rudd, Anthony G.;Wolfe, Charles D. A.
通讯作者：
Wolfe, Charles D. A.
DOI：
10.1016/j.amjopharm.2007.12.002
发表时间：
2007-12-01
期刊：
The American journal of geriatric pharmacotherapy
影响因子：
--
作者：
Hajjar, Emily R;Cafiero, Angela C;Hanlon, Joseph T
通讯作者：
Hanlon, Joseph T
影响因子：
8.3
作者：
Lees, Rosalind;Selvarajah, Johann;Quinn, Terence J.
通讯作者：
Quinn, Terence J.
影响因子：
8.3
作者：
Chroinin, Danielle Ni;Callaly, Elizabeth L.;Kelly, Peter J.
通讯作者：
Kelly, Peter J.
影响因子：
3.4
作者：
Aben, I;Verhey, F;Honig, A
通讯作者：
Honig, A