title: Gait measures as predictors of poststroke cognitive function: evidence from the TABASCO study.
abstract: OBJECTIVE
  Patients with stroke are at risk for developing cognitive impairment. We tested whether the assessment of balance and gait can enhance the prediction of long-term cognitive outcome in stroke survivors.
  
  
  METHODS
  Participants were patients with first-ever, mild-moderate ischemic stroke or transient ischemic attack from the Tel Aviv Brain Acute Stroke Cohort (TABASCO) study, a large prospective cohort study, who underwent 3-T MRI and were followed for ≥2 years using neurological, neuropsychological, and mobility examinations 6, 12, and 24 months after the index event.
  
  
  RESULTS
  Data were available for 298 patients (age: 66.7±9.6 years). Forty-six participants (15.4%) developed cognitive decline (CD) over the 2 years of follow-up. The CD group and cognitively intact group did not differ in their neurological deficits or in their infarct volume or location. Nonetheless, 6 months after stroke, the Timed Up and Go test took longer in those who later developed CD (P<0.001). Additionally, the CD group also had lower Berg Balance Scale scores (P<0.001), slower gait (P<0.001), and fewer correct answers during dual-task walking (P=0.006). Separate analyses of the patients with transient ischemic attack revealed similar results. Multivariate regression analysis showed that Timed Up and Go times >12 s at 6 months after stroke/transient ischemic attack was a significant independent risk marker of CD 24 months after stroke (odds ratio=6.07, 95% confidence interval: 1.36-27.15).
  
  
  CONCLUSIONS
  These results suggest that measures of balance and gait are significant risk markers of cognitive status 2 years after stroke. Relatively simple, performance-based tests of mobility may enhance the identification of stroke/transient ischemic attack survivors who have an increased risk of developing CD.
  
  
  BACKGROUND
  URL: http://www.clinicaltrials.gov. Unique identifier: NCT01926691.
authors: From the Stroke Unit and the Center for the Study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Medical Center, Tel Aviv, Israel (E.B.A., S.-S.T., E.K., H.H., L.S., E.A., N.G., A. Mike, A.H., A.W., A. Mirelman, N.M.B.); and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (E.B.A., A.D.K., E.K., H.H., E.A., N.G., N.M.B., J.M.H.).
authors: Einor
authors: E
authors: Ben Assayag
authors: From the Stroke Unit and the Center for the Study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Medical Center, Tel Aviv, Israel (E.B.A., S.-S.T., E.K., H.H., L.S., E.A., N.G., A. Mike, A.H., A.W., A. Mirelman, N.M.B.); and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (E.B.A., A.D.K., E.K., H.H., E.A., N.G., N.M.B., J.M.H.).
authors: Shani
authors: S
authors: Shenhar-Tsarfaty
authors: From the Stroke Unit and the Center for the Study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Medical Center, Tel Aviv, Israel (E.B.A., S.-S.T., E.K., H.H., L.S., E.A., N.G., A. Mike, A.H., A.W., A. Mirelman, N.M.B.); and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (E.B.A., A.D.K., E.K., H.H., E.A., N.G., N.M.B., J.M.H.).
authors: Amos D
authors: AD
authors: Korczyn
authors: From the Stroke Unit and the Center for the Study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Medical Center, Tel Aviv, Israel (E.B.A., S.-S.T., E.K., H.H., L.S., E.A., N.G., A. Mike, A.H., A.W., A. Mirelman, N.M.B.); and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (E.B.A., A.D.K., E.K., H.H., E.A., N.G., N.M.B., J.M.H.).
authors: Efrat
authors: E
authors: Kliper
authors: From the Stroke Unit and the Center for the Study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Medical Center, Tel Aviv, Israel (E.B.A., S.-S.T., E.K., H.H., L.S., E.A., N.G., A. Mike, A.H., A.W., A. Mirelman, N.M.B.); and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (E.B.A., A.D.K., E.K., H.H., E.A., N.G., N.M.B., J.M.H.).
authors: Hen
authors: H
authors: Hallevi
authors: From the Stroke Unit and the Center for the Study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Medical Center, Tel Aviv, Israel (E.B.A., S.-S.T., E.K., H.H., L.S., E.A., N.G., A. Mike, A.H., A.W., A. Mirelman, N.M.B.); and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (E.B.A., A.D.K., E.K., H.H., E.A., N.G., N.M.B., J.M.H.).
authors: Ludmila
authors: L
authors: Shopin
authors: From the Stroke Unit and the Center for the Study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Medical Center, Tel Aviv, Israel (E.B.A., S.-S.T., E.K., H.H., L.S., E.A., N.G., A. Mike, A.H., A.W., A. Mirelman, N.M.B.); and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (E.B.A., A.D.K., E.K., H.H., E.A., N.G., N.M.B., J.M.H.).
authors: Eitan
authors: E
authors: Auriel
authors: From the Stroke Unit and the Center for the Study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Medical Center, Tel Aviv, Israel (E.B.A., S.-S.T., E.K., H.H., L.S., E.A., N.G., A. Mike, A.H., A.W., A. Mirelman, N.M.B.); and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (E.B.A., A.D.K., E.K., H.H., E.A., N.G., N.M.B., J.M.H.).
authors: Nir
authors: N
authors: Giladi
authors: From the Stroke Unit and the Center for the Study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Medical Center, Tel Aviv, Israel (E.B.A., S.-S.T., E.K., H.H., L.S., E.A., N.G., A. Mike, A.H., A.W., A. Mirelman, N.M.B.); and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (E.B.A., A.D.K., E.K., H.H., E.A., N.G., N.M.B., J.M.H.).
authors: Anat
authors: A
authors: Mike
authors: From the Stroke Unit and the Center for the Study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Medical Center, Tel Aviv, Israel (E.B.A., S.-S.T., E.K., H.H., L.S., E.A., N.G., A. Mike, A.H., A.W., A. Mirelman, N.M.B.); and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (E.B.A., A.D.K., E.K., H.H., E.A., N.G., N.M.B., J.M.H.).
authors: Anat
authors: A
authors: Halevy
authors: From the Stroke Unit and the Center for the Study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Medical Center, Tel Aviv, Israel (E.B.A., S.-S.T., E.K., H.H., L.S., E.A., N.G., A. Mike, A.H., A.W., A. Mirelman, N.M.B.); and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (E.B.A., A.D.K., E.K., H.H., E.A., N.G., N.M.B., J.M.H.).
authors: Aner
authors: A
authors: Weiss
authors: From the Stroke Unit and the Center for the Study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Medical Center, Tel Aviv, Israel (E.B.A., S.-S.T., E.K., H.H., L.S., E.A., N.G., A. Mike, A.H., A.W., A. Mirelman, N.M.B.); and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (E.B.A., A.D.K., E.K., H.H., E.A., N.G., N.M.B., J.M.H.).
authors: Anat
authors: A
authors: Mirelman
authors: From the Stroke Unit and the Center for the Study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Medical Center, Tel Aviv, Israel (E.B.A., S.-S.T., E.K., H.H., L.S., E.A., N.G., A. Mike, A.H., A.W., A. Mirelman, N.M.B.); and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (E.B.A., A.D.K., E.K., H.H., E.A., N.G., N.M.B., J.M.H.). strokeun@tlvmc.gov.il.
authors: Natan M
authors: NM
authors: Bornstein
authors: From the Stroke Unit and the Center for the Study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Medical Center, Tel Aviv, Israel (E.B.A., S.-S.T., E.K., H.H., L.S., E.A., N.G., A. Mike, A.H., A.W., A. Mirelman, N.M.B.); and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (E.B.A., A.D.K., E.K., H.H., E.A., N.G., N.M.B., J.M.H.).
authors: Jeffrey M
authors: JM
authors: Hausdorff
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D003072:Cognition Disorders / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D004856:Postural Balance / Q000502:physiology*; D012306:Risk; D020521:Stroke / Q000150:complications / Q000503:physiopathology*
chemical_list: D015415:Biomarkers
keywords: gait; mild cognitive impairment; stroke