Increased risk of cognitive impairment 3 months after mild to moderate first-ever stroke: a Community-Based Prospective Study of Nonaphasic English-Speaking Survivors.
OBJECTIVE
Results of hospital-based studies indicate a high risk of cognitive impairment 3 months after stroke. There are no comprehensive data on this issue from prospective community-based studies comparing first-ever stroke patients with stroke-free subjects.


METHODS
We administered a comprehensive neuropsychological battery to 99 community-based nonaphasic survivors of first-ever stroke at 3 months and 99 age- and sex-matched (1:1) stroke-free individuals. Domain-specific cognitive deficits were identified by blinded neuropsychological consensus.


METHODS
Stroke patients were more likely to suffer any cognitive impairment (relative risk [RR], 1.5; 95% CI, 1.1 to 2.1) attributable mainly to a greater risk of single-domain cognitive impairment (RR, 2.8; 95% CI, 1.5 to 5.3) but not multiple-domain cognitive impairment (RR, 1.2; 95% CI, 0.8 to 1.9).


CONCLUSIONS
In this community-based study, a first-ever stroke of mild to moderate severity was associated with a significant risk of cognitive impairment at 3 months, even in the absence of clinical aphasia. This was due primarily to an increased risk of solitary deficits rather than generalized deficits.
Srikanth
Velandai K
VK
Epidemiology Division, National Stroke Research Institute, Austin & Repatriation Medical Center, Melbourne, Australia. velandai.srikanth@utas.edu.au
Thrift
Amanda G
AG
Saling
Michael M
MM
Anderson
Jacqueline F I
JF
Dewey
Helen M
HM
Macdonell
Richard A L
RA
Donnan
Geoffrey A
GA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000453:epidemiology* / Q000209:etiology; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006429:Hemiplegia / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008569:Memory Disorders / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D018579:Patient Selection; D011446:Prospective Studies; D012306:Risk; D015983:Selection Bias; D012720:Severity of Illness Index; D016037:Single-Blind Method; D020521:Stroke / Q000150:complications* / Q000523:psychology; D017741:Survivors; D014739:Victoria / Q000453:epidemiology