Frequency and Risk Factors of Vascular Cognitive Impairment Three Months after Ischemic Stroke in China: The Chongqing Stroke Study

Zhou, David H.D.; Wang, John Y J; Li, Jingcheng; Deng, Juan; Gao, Chang-Yue; Man-e, Chen

doi:10.1159/000081055

Cited by 59 publications

(50 citation statements)

References 54 publications

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“…In several countries in Asia and Latin America, up to 10% of dementia cases are diagnosed with mixed dementia 30,40. Up to 30% of Chinese people in urban areas develop post-stroke cognitive impairment or delayed dementia after stroke 86–88. However, the prevalence of vascular cognitive impairment that involves all domains of cognitive function and causes of vascular injury is likely to be greater than that of VaD 89…”

Section: Subtypes Of Dementiamentioning

confidence: 99%

Alzheimer's disease and vascular dementia in developing countries: prevalence, management, and risk factors

Kalaria

Maestre

Arizaga

et al. 2008

The Lancet Neurology

1,051

739

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Despite mortality due to communicable diseases, poverty, and human conflicts, dementia incidence is destined to increase in the developing world in tandem with the ageing population. Current data from developing countries suggest that age-adjusted dementia prevalence estimates in 65 year olds are high (≥5%) in certain Asian and Latin American countries, but consistently low (1-3%) in India and sub-Saharan Africa; Alzheimer's disease accounts for 60% whereas vascular dementia accounts for ∼30% of the prevalence. Early-onset familial forms of dementia with single-gene defects occur in Latin America, Asia, and Africa. Illiteracy remains a risk factor for dementia. The APOE ε4 allele does not influence dementia progression in sub-Saharan Africans. Vascular factors, such as hypertension and type 2 diabetes, are likely to increase the burden of dementia. Use of traditional diets and medicinal plant extracts might aid prevention and treatment. Dementia costs in developing countries are estimated to be US$73 billion yearly, but care demands social protection, which seems scarce in these regions.

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Section: Subtypes Of Dementiamentioning

confidence: 99%

Alzheimer's disease and vascular dementia in developing countries: prevalence, management, and risk factors

Kalaria

Maestre

Arizaga

et al. 2008

The Lancet Neurology

1,051

739

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show abstract

“…There was an interaction between depression and stroke side, suggesting left-lesioned depressed patients may be more likely than right-lesioned to be impaired. While worse cognitive functions in left-hemispheric lesions have already been reported in recent studies [2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47], the relationship between stroke side and depression remains questionable [13]. …”

Section: Discussionmentioning

confidence: 90%

“…We had previously shown that CDF was underlain by a working memory deficit [6]. Performing working memory tasks is related to the activation of the prefrontal and posterior parietal cortex [32,33,34], while executive dysfunctioning has been reported in subacute stroke involving the caudate nucleus [35]. The MCA supplying these regions being involved in 78.9% of patients with CDF = 2, the association between the MCA territory and CDF could be expected.…”

Section: Discussionmentioning

confidence: 99%

Predicting Cognitive Dysfunctioning in Nondemented Patients Early after Stroke

et al. 2010

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Background: Cognitive dysfunctioning (CDF) is an important issue in stroke, interfering with recovery and social dysfunctioning. We aimed to investigate the clinical and imaging correlates of CDF in patients with a first-ever subacute ischemic stroke and no dementia. Methods: We evaluated CDF 15 days after stroke in a prospective cohort of consecutive patients with a Mini Mental State Examination score ≧23 using a comprehensive neuropsychological battery. CDF was ranked into 3 categories according to Z scores calculated for each test and adjusted for age and education. CDF was analyzed in relation to stroke features. Imaging was assessed using MRI. An ordinal regression procedure was used to determine the clinical correlates of CDF and to compute probabilities. Results: Cognitive evaluation was achieved in 177 consecutive patients (age 50.0 ± 16.0 years). In bivariate analysis, CDF was associated with age, low level of education, depression, neurological deficit at day 15, stroke subtype, arterial territory and leukoaraiosis but not with stroke volume or location. The predictors of CDF were NIHSS score at day 15 (OR = 1.35; 95% CI = 1.05–1.73), middle cerebral artery infarct (OR = 2.96; 95% CI = 1.30–6.73), depression interacting with left stroke side (OR = 1.09; 95% CI = 1.03–1.15), and female gender interacting with high level of education (OR = 0.209; 95% CI = 0.085–0.514). Conclusions: Stroke features correlate with CDF in nondemented patients. These simple criteria may help to predict CDF at bedside in the subacute phase after stroke and to recommend a neuropsychological evaluation for patients’ management. Modeling CDF soon after stroke using simple neurological criteria may be a useful tool for designing clinical trials.

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“…41 All previous strokes and multiple lesions undoubtedly increase the risk of post-stroke cognitive impairment. 4,42 It has been found that a more severe clinical deficit at stroke onset is associated with a higher risk of post-stroke dementia. 43,44 Special attention is paid to the "strategic infarcts", i.e.…”

Section: Stroke Characteristicsmentioning

confidence: 99%

Post-Stroke Cognitive Impairment – Phenomenology and Prognostic Factors

Danovska¹,

Stamenov²,

Alexandrova³

et al. 2012

JofIMAB

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Stroke patients are at higher risk of developing cognitive impairment. Cognitive dysfunctions, especially progressive ones, worsen stroke prognosis and outcome. A longitudinal follow-up of cognitive disorders, however, is rendered difficult by their heterogeneity and the lack of definitions generally agreed upon. Stroke is a major cause of cognitive deficit. The identification of risk factors, clinical determinants and laboratory markers of post-stroke cognitive deficit may help detect patients at increased risk of cognitive deterioration, and prevent or delay the occurrence of poststroke cognitive impairments. Though inflammatory processes have been implicated in the pathogenesis of stroke, their role in the complex pathophysiological mechanisms of post-stroke cognitive impairment is not completely understood. Evidence suggests that elevated serum Creactive protein is associated with both the increased risk of stroke and post-stroke cognitive deficit. The hypothesis of a possible relationship between markers of systemic inflammation and cognitive dysfunctions raises the question of how rational the option of applying non-steroidal antiinflammatory drugs in a proper therapeutic window will be, especially during the acute phase of stroke, to prevent cognitive decline and dementia.

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Frequency and Risk Factors of Vascular Cognitive Impairment Three Months after Ischemic Stroke in China: The Chongqing Stroke Study

Cited by 59 publications

References 54 publications

Alzheimer's disease and vascular dementia in developing countries: prevalence, management, and risk factors

Alzheimer's disease and vascular dementia in developing countries: prevalence, management, and risk factors

Predicting Cognitive Dysfunctioning in Nondemented Patients Early after Stroke

Post-Stroke Cognitive Impairment – Phenomenology and Prognostic Factors

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