title: Cognitive impairment one year after ischemic stroke: predictorsand dynamics of significant determinants.
abstract: OBJECTIVE
  Evidence suggests that the risk for dementia increases after stroke. This study investigated the dynamics of the neurological and cognitive status of patients with no baseline dementia over a 1-year period after ischemic stroke.
  
  
  METHODS
  We examined 47 ischemic stroke patients admitted within 48 h of ictus. Their neurological and cognitive statuses, blood biochemical parameters, and microalbuminuria levels were prospectively evaluated over a 1-year period post-stroke.
  
  
  RESULTS
  A more severe neurological deficit was found in the cognitively impaired patients (P = 0.003). The NIHSS score over a 1-year follow-up period improved only in patients with normal cognition (P = 0.000). Time-varying dynamics of the MMSE score were observed in both patient groups (P = 0.000). Age (Р = 0.000), education (Р = 0.004), sex (Р = 0.041), history of diabetes (Р = 0.045), and serum high sensitive C-reactive protein (hs-CRP) on admission (Р = 0.003) were significant determinants of cognitive decline 1 year after a stroke. The albumin-to-creatinine ratio was high during the whole follow-up period in the cognitively impaired group after adjusting for sex and age (P = 0.010). Binary logistic regression showed that hs-CRP (Р = 0.013) and age (Р = 0.010) were independent predictors of patients' cognitive status 1 year after stroke.
  
  
  CONCLUSIONS
  The level of inflammatory markers could be considered as an additional criterion of long-term cognitive impairment.
authors.affiliation: Department of Biophysics, Medical University, Pleven, Bulgaria.
authors.forename: Margarita Lubomirova
authors.initials: ML
authors.lastname: Alexandrova
authors.affiliation: Department of Neurology, University Hospital, Pleven, Bulgaria.
authors.forename: Maya Penkova
authors.initials: MP
authors.lastname: Danovska
mesh_terms: D002545:Brain Ischemia; D002097:C-Reactive Protein; D060825:Cognitive Dysfunction; D006801:Humans; D012307:Risk Factors; D020521:Stroke
chemical_list: D002097:C-Reactive Protein
keywords: Cognitive impairment; endothelial dysfunction; hs-CRP; ischemic stroke; long-term prognosis