Cognitive Impairment and Dementia After Intracerebral Hemorrhage: A Cross-sectional Study of a Hospital-based Series

Garcia, P.-Y.; Roussel, Martine; Bugnicourt, Jean Marc; Lamy, Chantal; Canaple, Sandrine; Peltier, J.; Loas, Gwenolé; Deramond, H.; Godefroy, Olivier

doi:10.1016/j.jstrokecerebrovasdis.2011.06.013

Cited by 79 publications

(67 citation statements)

References 39 publications

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“…2,3,29 The only previous study investigating cognitive decline after ICH unfortunately did not take these characteristics into account. 10 We found that prognostic factors for cognitive decline after an ICH were already present when ICH occurs, suggesting a process of ongoing cognitive impairment instead of new-onset decline induced by the ICH itself. 29 The impact of cortical atrophy is in line with this hypothesis and both cortical atrophy and preexisting cognitive impairment may hint toward an underlying neurodegenerative process.…”

Section: Discussionmentioning

confidence: 67%

“…6,7 In the only previous study on cognitive outcome after ICH, previous stroke did not predict dementia. 10 This study may have had a limited sample size (n=78) and a retrospective design.…”

Section: Discussionmentioning

confidence: 99%

“…To date, only 1 retrospective study investigated 78 ICH patients and found that dementia was present in roughly 1 of 4 (23%; 95% confidence interval, 13% to 32%) patients 3 years after an ICH. 10 To the best of our knowledge, no prospective study has ever focused on cognitive decline over time in ICH patients. Cognitive decline does not only incorporate a diagnosis of dementia but also more subtle (mild) cognitive impairment that may adversely influence outcome after stroke.…”

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confidence: 99%

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Prognostic Factors for Cognitive Decline After Intracerebral Hemorrhage

Benedictus

Hochart

Rossi³

et al. 2015

Stroke

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Background and Purpose-Stroke and dementia are closely related, but no prospective study ever focused on poststroke cognitive decline in patients with intracerebral hemorrhage (ICH). We aimed to determine prognostic factors for cognitive decline in patients with ICH. Methods-We prospectively included 167 consecutive ICH survivors without preexisting dementia from the Prognosis of Intra-Cerebral Hemorrhage (PITCH) cohort. Median follow-up was 4 years (interquartile range, 2.3-5.4). We explored factors associated with cognitive decline using linear mixed models. Cognitive decline was determined based on repeated mini-mental state examination. We investigated each prognostic factor separately in univariate models. Next, we constructed clinical and radiological multivariable models. In a sensitivity analysis, we excluded patients with preexisting cognitive impairment. Results-Median age was 64 (interquartile range, 53-75) years, 69 (41%) patients were women, and median mini-mental state examination at 6 months was 27 (interquartile range, 23-29

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Prognostic Factors for Cognitive Decline After Intracerebral Hemorrhage

Benedictus

Hochart

Rossi³

et al. 2015

Stroke

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“…1), 159 articles were analyzed and 16 studies were selected, corresponding to a total of 3,087 patients. Ineligible studies on post-stroke NCD included cross-sectional studies resulting in variable post-stroke intervals [10], non-consecutive patients [11-16], studies which failed to report the rates of both mild and major post-stroke NCD, and studies that did not use a neuropsychological battery [12-14, 17-44]. …”

Section: Resultsmentioning

confidence: 99%

Systematic Review and Meta-Analysis of Prevalence in Post-Stroke Neurocognitive Disorders in Hospital-Based Studies

Barbay¹,

Diouf²,

Roussel³

et al. 2018

Dement Geriatr Cogn Disord

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Background/Aims: Post-stroke neurocognitive disorders (post-stroke NCD) have been reported with a very variable prevalence. Methods: Based on a systematic literature search, hospital-based studies published between January 1990 and September 2015 were selected when they reported the prevalence of total, mild, and major post-stroke NCD diagnosed by using specified criteria. Factors affecting prevalence were assessed using meta-regression analysis. Results: Among the 7,440 references evaluated, 16 hospital-based studies were selected, corresponding to a total of 3,087 patients. The overall prevalence of total post-stroke NCD was 53.4% (95% CI: 46.9–59.8): 36.4% for mild post-stroke NCD (95% CI: 29–43.8) and 16.5% (95% CI: 12.1–20.8) for major post-stroke NCD. The overall prevalence was mainly influenced by the threshold score used for categorization (p = 0.0001) and, in the subgroup of studies using a conservative threshold (i.e., ≤7th percentile), by the recurrent stroke rate (p = 0.0005). The prevalence of major post-stroke NCD was mainly influenced by age (p = 0.003). Conclusion: More than half of stroke survivors experience post-stroke NCD, corresponding to mild post-stroke NCD in two-thirds of cases and major post-stroke NCD in one-third of cases. Harmonization of stroke assessment and cognitive score thresholds is urgently needed to allow more accurate estimation of post-stroke NCD prevalence, especially mild post-stroke NCD.

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“…The reported rate of long-term cognitive impairment up to 4 years after ICH varies widely from 23 to 61% [3-5, 9, 10], which may be due to different patient population or the definition of cognitive impairment. Only one small study ( n = 29) found that 27.6% of the patients developed cognitive impairment at 3 months after ICH [6].…”

Section: Discussionmentioning

confidence: 99%

Early Cognitive Impairment after Intracerebral Hemorrhage in the INTERACT1 Study

et al. 2017

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Background: Data on cognitive impairment after acute intracerebral hemorrhage (ICH) are limited. This study is aimed at determining the frequency and predictors of cognitive impairment among participants of the pilot phase, Intensive Blood Pressure (BP) Reduction in Acute Cerebral Hemorrhage Trial (INTERACT1). Methods: INTERACT1 was an open randomized trial of early intensive (target systolic BP <140 mm Hg) compared with contemporaneous guideline-recommended BP lowering in 404 patients with elevated systolic BP (150–220 mm Hg) within 6 h of ICH onset. Cognitive impairment was defined by scores ≤24 on the Mini-Mental State Examination (MMSE) assessed by interview on follow-up at 90 days. Results: A total of 231 (64.5%) of 358 90-day survivors had MMSE scores for analyses, and 75 (32.5%) had cognitive impairment. In multivariable analysis, older age (OR 2.48, 95% CI 1.73–3.56 per 10-year increase; p < 0.001), female sex (OR 2.06, 95% CI 1.00–4.23; p = 0.049), prior ICH (OR 2.87, 95% CI 1.08–7.65; p = 0.035), high baseline National Institute of Health Stroke Scale score (OR 1.06, 95% CI 1.00–1.13; p = 0.044), and high mean systolic BP over the first 24 h post-randomization (OR 1.34, 95% CI 1.07–1.68/10 mm Hg increase; p = 0.011) were independently associated with cognitive impairment. Conclusions: One third of patients have significant cognitive impairment early after ICH, which is more frequent in the elderly, females, those with prior ICH, and more severe initial neurological deficit and with persistently high early systolic BP.

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Cognitive Impairment and Dementia After Intracerebral Hemorrhage: A Cross-sectional Study of a Hospital-based Series

Cited by 79 publications

References 39 publications

Prognostic Factors for Cognitive Decline After Intracerebral Hemorrhage

Prognostic Factors for Cognitive Decline After Intracerebral Hemorrhage

Systematic Review and Meta-Analysis of Prevalence in Post-Stroke Neurocognitive Disorders in Hospital-Based Studies

Early Cognitive Impairment after Intracerebral Hemorrhage in the INTERACT1 Study

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