title: Clinico-radiological predictors of vascular cognitive impairment (VCI) in patients with stroke: a prospective observational study.
abstract: OBJECTIVE
  Cognitive dysfunction occurs commonly following stroke and varies in severity. This study was aimed to determine the clinical, neuro-imaging, laboratory predictors of post stroke cognitive impairment and factors related to poor functional outcome in patients with post-stroke vascular cognitive impairment (VCI).
  
  
  METHODS
  We prospectively evaluated 102 of 240 consecutive stroke patients for 6 months after incident stroke for development of VCI. Patients with VCI comprised of those with VCI-no dementia (VCIND) and vascular dementia (VaD). Functional outcome was assessed by modified Barthel index (MBI).
  
  
  RESULTS
  Frequency of post-stroke VCI was 45.1% (46/102): 26.5% (27/102) having VCI-ND and 18.6% (19/102) having VaD. Patients with VCI were more likely to have lower educational and socioeconomic status, diabetes, hypertension, prior stroke, multiple risk factors, urinary incontinence, gait abnormality, peripheral signs of atherosclerosis, higher blood sugar level on admission and LDL levels, strategic site lesion, higher ARWMC (age related white matter changes) score, worse stroke severity (NIHSS) and functional outcome scores. On logistic regression analysis, lower educational status, strategic site lesion, higher ARWMC score and baseline stroke severity score were found to independently predict the risk of developing VCI. Worse stroke severity (NIHSS) scores and functional status scores at baseline predicted poor outcome in patients with VCI.
  
  
  CONCLUSIONS
  Post-stroke cognitive impairment is frequent and is associated with poor functional outcome. Predictors like lower educational status, strategic site lesion, greater severity of age related white matter changes and baseline stroke severity independently contributed to the risk of developing VCI in stroke patients.
authors.affiliation: Department of Neurology, King George's Medical University, Lucknow, UP, India.
authors.forename: Tejendra Sukdeo
authors.initials: TS
authors.lastname: Chaudhari
authors.affiliation: Department of Neurology, King George's Medical University, Lucknow, UP, India. Electronic address: drrajeshverma32@yahoo.com.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Verma
authors.affiliation: Department of Neurology, King George's Medical University, Lucknow, UP, India.
authors.forename: Ravindra Kumar
authors.initials: RK
authors.lastname: Garg
authors.affiliation: Department of Neurology, King George's Medical University, Lucknow, UP, India.
authors.forename: Manish Kumar
authors.initials: MK
authors.lastname: Singh
authors.affiliation: Department of Neurology, King George's Medical University, Lucknow, UP, India.
authors.forename: Hardeep Singh
authors.initials: HS
authors.lastname: Malhotra
authors.affiliation: Department of Neurology, King George's Medical University, Lucknow, UP, India.
authors.forename: Praveen Kumar
authors.initials: PK
authors.lastname: Sharma
mesh_terms: D000368:Aged; D001786:Blood Glucose; D008078:Cholesterol, LDL / Q000097:blood; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D015140:Dementia, Vascular / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D059906:Neuroimaging; D009483:Neuropsychological Tests; D019370:Observation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications*
chemical_list: D001786:Blood Glucose; D008078:Cholesterol, LDL
keywords: Age related white matter changes; NINDS–AIREN criteria; Post stroke dementia; Risk factors; Strategic site lesion; Vascular cognitive impairment