title: Post-stroke cognitive impairment: high prevalence and determining factors in a cohort of mild stroke.
abstract: BACKGROUND
  Because of the aging population and a rise in the number of stroke survivors, the prevalence of post-stroke cognitive impairment (PSCI) is increasing.
  
  
  OBJECTIVE
  To identify the factors associated with 3-month PSCI.
  
  
  METHODS
  All consecutive stroke patients without pre-stroke dementia, mild cognitive disorders, or severe aphasia hospitalized in the Neurology Department of Dijon, University Hospital, France (November 2010 - February 2012) were included in this prospective cohort study. Demographics, vascular risk factors, and stroke data were collected. A first cognitive evaluation was performed during the hospitalization using the Mini-Mental State Exam (MMSE) and the Montreal Cognitive Assessment (MOCA). Patients assessable at 3 months were categorized as cognitively impaired if the MMSE score was ≤26/30 and MOCA <26/30 or if the neuropsychological battery confirmed PSCI when the MMSE and MOCA were discordant. Multivariable logistic models were used to determine factors associated with 3-month PSCI.
  
  
  RESULTS
  Among the 280 patients included, 220 were assessable at 3 months. The overall frequency of 3-month PSCI was 47.3%, whereas that of dementia was 7.7%. In multivariable analyses, 3-month PSCI was associated with age, low education level, a history of diabetes mellitus, acute confusion, silent infarcts, and functional handicap at discharge. MMSE and MOCA scores during hospitalization were associated with 3-month PSCI (OR = 0.63; 95% CI: 0.54-0.74; p < 0.0001 and OR = 0.67; 95% CI: 0.59-0.76; p < 0.0001, respectively).
  
  
  CONCLUSIONS
  Our study underlines the high frequency of PSCI in a cohort of mild stroke. The early cognitive diagnosis of stroke patients could be useful by helping physicians to identify those at a high risk of developing PSCI.
authors.affiliation: Memory Centre, Department of Neurology, University Hospital, University of Burgundy, Stroke Registry, Dijon, France.
authors.forename: Agnès
authors.initials: A
authors.lastname: Jacquin
authors.affiliation: Clinical Investigation Center, Clinical Epidemiology/Clinical Trials, University Hospital, Dijon, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Binquet
authors.affiliation: Memory Centre, Department of Neurology, University Hospital, University of Burgundy, Stroke Registry, Dijon, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Rouaud
authors.affiliation: Memory Centre, Department of Neurology, University Hospital, University of Burgundy, Stroke Registry, Dijon, France.
authors.forename: Anny
authors.initials: A
authors.lastname: Graule-Petot
authors.affiliation: Memory Centre, Department of Neurology, University Hospital, University of Burgundy, Stroke Registry, Dijon, France.
authors.forename: Benoit
authors.initials: B
authors.lastname: Daubail
authors.affiliation: Memory Centre, Department of Neurology, University Hospital, University of Burgundy, Stroke Registry, Dijon, France.
authors.forename: Guy-Victor
authors.initials: GV
authors.lastname: Osseby
authors.affiliation: Clinical Investigation Center, Clinical Epidemiology/Clinical Trials, University Hospital, Dijon, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Bonithon-Kopp
authors.affiliation: Memory Centre, Department of Neurology, University Hospital, University of Burgundy, Stroke Registry, Dijon, France.
authors.forename: Maurice
authors.initials: M
authors.lastname: Giroud
authors.affiliation: Memory Centre, Department of Neurology, University Hospital, University of Burgundy, Stroke Registry, Dijon, France.
authors.forename: Yannick
authors.initials: Y
authors.lastname: Béjot
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000453:epidemiology* / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests; D019370:Observation; D015995:Prevalence; D020521:Stroke / Q000150:complications* / Q000453:epidemiology
keywords: Cognitive impairment; early cognitive assessment; prevalence; stroke