Prevalence of Poststroke Cognitive Impairment South London Stroke Register 1995-2010
Prevalence of Poststroke Cognitive Impairment South London Stroke Register 1995-2010
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DOI：
10.1161/strokeaha.112.670844
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发表时间：
2013-01-01
期刊：
影响因子：
8.3
通讯作者：
Wolfe, Charles D. A.
中科院分区：
文献类型：
--
作者：
Douiri, Abdel;Rudd, Anthony G.;Wolfe, Charles D. A.
背景与目的：脑卒中是一种常见的长期疾病，随着人口老龄化，其发病率不断上升。本研究评估了首次中风后认知障碍患病率的时间变化，按社会人口统计学、血管危险因素和中风亚型分层，直至中风后15年。方法：数据收集于1995年至2010年（n=4212），来自社区为基础的南伦敦卒中登记，涵盖市中心多民族人口277817人。患者在发病时、3个月后和此后每年使用简短精神测试或简易精神状态检查评估认知功能。所有的估计都根据欧洲标准进行了年龄调整。结果：卒中后3个月和年度随访时认知障碍的总体患病率保持相对不变，为22%（3个月时为24% [95% CI， 21.2-27.8]； 5年时为22%[17.4-26.8]；14年时为21%[3.6-63.8]）。在多变量分析中，脑卒中后认知障碍患病率随着年龄的增长（每年2%[1-3]）、种族（黑人组高出2.2[1.65-2.89]倍）和社会经济地位（体力劳动者增加42%[8-86]）而增加。小血管闭塞和腔隙性梗死患者的认知功能障碍有明显的进行性趋势（平均年变化百分比：卒中后5年分别为10%[7.9-12.8]和2%[0.3-2.7]）。结论：随着时间的推移，中风后认知障碍的患病率一直居高不下，其变化主要由社会人口统计学特征来解释。鉴于人口增长和人口老龄化，需要有效的预防策略和卒中后监测来管理认知障碍幸存者。(中风。2013;44:138 - 145)。
Background and Purpose-Stroke is a common long-term condition with an increasing incidence as the population ages. This study evaluates temporal changes in the prevalence of cognitive impairment after first-ever stroke stratified by sociodemography, vascular risk factors, and stroke subtypes, up to 15 years after stroke.Methods-Data were collected between 1995 and 2010 (n=4212) from the community-based South London Stroke Register covering an inner-city multiethnic population of 271 817 inhabitants. Patients were assessed for cognitive function using Abbreviated Mental Test or Mini-Mental State Examination at the onset, 3 months, and annually thereafter. All estimates were age adjusted to the European standard.Results-The overall prevalence of cognitive impairment 3 months after stroke and at annual follow-up remained relatively unchanged at 22% (24% [95% CI, 21.2-27.8] at 3 months; 22% [17.4-26.8] at 5 years to 21% [3.6-63.8] at 14 years). In multivariate analyses, the poststroke prevalence ratio of cognitive impairment increased with older age (2% [1-3] for each year of age), ethnicity (2.2 [1.65-2.89]-fold higher among black group) and socioeconomic status (42% [8-86] increased among manual workers). A significant, progressive trend of cognitive impairment was observed among patients with small vessel occlusion and lacunar infarction (average annual percentage change: 10% [7.9-12.8] and 2% [0.3-2.7], respectively, up to 5 years after stroke).Conclusions-The prevalence of cognitive impairment after stroke remains persistently high over time, with variations being predominantly explained by sociodemographic characteristics. Given population growth and ageing demographics, effective preventive strategies and poststroke surveillance are needed to manage survivors with cognitive impairment. (Stroke. 2013;44:138-145.)