title: The prognostic effects of poststroke cognitive impairment no dementia and domain-specific cognitive impairments in nondisabled ischemic stroke patients.
abstract: OBJECTIVE
  There is some evidence that poststroke dementia, cognitive impairment no dementia (CIND), and mild cognitive impairment predict for poor outcomes such as dementia, death, and institutionalization. However, few studies have examined the prognostic value of CIND, CIND severity, and domain impairments in a poststroke cohort.
  
  
  METHODS
  A cohort of ischemic stroke patients with baseline cognitive assessments 3 months poststroke were followed up annually for outcomes of dependency, vascular events, and death for up to 5 years. Univariate and multivariate Cox proportional regression was performed to determine the ability CIND, CIND severity, and domain impairments to predict dependency, vascular outcomes, and death.
  
  
  RESULTS
  Four-hundred nineteen patients without dementia (mean age 60±11 years, 32% female) were followed for a mean of 3.2 years. Older age, diabetes, more severe strokes, CIND-mild, and CIND-moderate were independently predictive of dependency. There were no independent predictors of recurrent vascular events. Older age, diabetes, and CIND-moderate were independently predictive of death. In analyses of individual cognitive domains, impairments in visuomotor speed were independently predictive of dependency.
  
  
  CONCLUSIONS
  In poststroke patients, CIND predicts dependency and death, while CIND severity discriminates patients with poor survival. Impairments in visuomotor speed independently predict dependency.
  
  
  BACKGROUND
  URL: http://clinicaltrials.gov. Unique Identifier: NCT00161070.
authors.affiliation: Center for Molecular Epidemiology, National University of Singapore. nkaavya@gmail.com
authors.forename: Kaavya
authors.initials: K
authors.lastname: Narasimhalu
authors.forename: Sandy
authors.initials: S
authors.lastname: Ang
authors.forename: Deidre Anne
authors.initials: DA
authors.lastname: De Silva
authors.forename: Meng-Cheong
authors.initials: MC
authors.lastname: Wong
authors.forename: Hui-Meng
authors.initials: HM
authors.lastname: Chang
authors.forename: Kee-Seng
authors.initials: KS
authors.lastname: Chia
authors.forename: Alexander P
authors.initials: AP
authors.lastname: Auchus
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Chen
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000401:mortality* / Q000523:psychology; D003072:Cognition Disorders / Q000401:mortality*; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000592:standards; D011379:Prognosis; D012720:Severity of Illness Index; D020521:Stroke / Q000401:mortality* / Q000523:psychology