Cognitive outcome in adults after bacterial meningitis.
OBJECTIVE
To evaluate cognitive outcome in adult survivors of bacterial meningitis.


METHODS
Data from three prospective multicentre studies were pooled and reanalysed, involving 155 adults surviving bacterial meningitis (79 after pneumococcal and 76 after meningococcal meningitis) and 72 healthy controls.


RESULTS
Cognitive impairment was found in 32% of patients and this proportion was similar for survivors of pneumococcal and meningococcal meningitis. Survivors of pneumococcal meningitis performed worse on memory tasks (p<0.001) and tended to be cognitively slower than survivors of meningococcal meningitis (p = 0.08). We found a diffuse pattern of cognitive impairment in which cognitive speed played the most important role. Cognitive performance was not related to time since meningitis; however, there was a positive association between time since meningitis and self-reported physical impairment (p<0.01). The frequency of cognitive impairment and the numbers of abnormal test results for patients with and without adjunctive dexamethasone were similar.


CONCLUSIONS
Adult survivors of bacterial meningitis are at risk of cognitive impairment, which consists mainly of cognitive slowness. The loss of cognitive speed is stable over time after bacterial meningitis; however, there is a significant improvement in subjective physical impairment in the years after bacterial meningitis. The use of dexamethasone was not associated with cognitive impairment.
Hoogman
Martine
M
Department of Neurology, Academic Medical Centre, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
van de Beek
Diederik
D
Weisfelt
Martijn
M
de Gans
Jan
J
Schmand
Ben
B
D000328:Adult; D017668:Age of Onset; D000704:Analysis of Variance; D015984:Causality; D003072:Cognition Disorders / Q000145:classification / Q000453:epidemiology*; D015897:Comorbidity; D003389:Cranial Nerve Diseases / Q000453:epidemiology; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008585:Meningitis, Meningococcal / Q000188:drug therapy / Q000453:epidemiology*; D008586:Meningitis, Pneumococcal / Q000188:drug therapy / Q000453:epidemiology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D016017:Odds Ratio; D017678:Sex Distribution
D003907:Dexamethasone