Hidden Dysfunctioning in Subacute Stroke

Jaillard, Assia; Naëgelé, Bernadette; Trabucco-Miguel, Sandra; LeBas, Jean François; Hommel, Marc

doi:10.1161/strokeaha.108.541144

Cited by 156 publications

(145 citation statements)

References 51 publications

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“…Together they possibly exert additive effects on cognitive decline. We found that the level of education, sex, and history of diabetes mellitus were significant determinants of cognitive decline 1 year after stroke, as shown in previous studies (13,14). However, these did not emerge as independent predictors of long-term cognitive status.…”

Section: Discussionsupporting

confidence: 90%

Cognitive impairment one year after ischemic stroke: predictorsand dynamics of significant determinants

Alexandrova¹,

Danovska²

2016

Turk J Med Sci

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Background/aim: 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. Materials and 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. Conclusion:The level of inflammatory markers could be considered as an additional criterion of long-term cognitive impairment.

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Section: Discussionsupporting

confidence: 90%

Cognitive impairment one year after ischemic stroke: predictorsand dynamics of significant determinants

Alexandrova¹,

Danovska²

2016

Turk J Med Sci

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“…Cognitive and perceptual impairments can have devastating impacts if they are not diagnosed 2,28 . They have a negative impact on activities and participation as shown in the results of the current study.…”

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confidence: 99%

“…Their disability grant application might be rejected or they might have difficulty with collating information and completing the required documentation as described in the results. Not identifying cognitive and perceptual deficits can hamper return to employment in people with little physical impairment 28,30,31 . Taking the above facts into consideration, it is of some concern that prior to participation in the study, only one participant had been formally tested with a standardised cognitive and perceptual evaluation measure.…”

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confidence: 99%

Impact of post-stroke impairments on activities and participation as experienced by stroke survivors in a Western Cape setting

Cawood¹,

Visagie²,

Mji

2016

S. Afr. j. occup. ther

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INTRODUCTION: This paper explores causal connections between impairments, activity limitations and participation restrictions after stroke. Understanding the impact of impairment on activities and participation can assist with determining optimal interventions. METHODS: The study population (N=267) of this descriptive study were public health care users, from the eastern sub-district of the Western Cape Metropole, who had had a stroke in 2009 or 2010. Fifty-three study participants were selected through stratified, proportional, random sampling. Data were collected using the Stroke Impact Scale-3.0 (SIS); the Modified Barthel Index (MBI); the Loewenstein Occupational Therapy Cognitive Assessment and a language screening test. Linear regressions to determine if impairments could be correlated with activity limitations and participation restrictions were done with Spearman rank correlations. T-tests were used to determine if impairments had any statistically significant impact on activities and participation. RESULTS: The mean SIS participation score was 31.3/100. Participation as measured by the SIS showed positive correlations with, and was impacted signifcantly by limb strength (r=0.49; p<0.01), visual perception (r=0.57; p<0.01), spatial perception (r=0.31; p=0.02), motor praxis (r=0.58; p<0.01), visuomotor organisation (r=0.50; p<0.01), and thinking operations (r=0.6l; p<0.01). The mean MBI score was 70.58/l00. MBI scores showed postive correlations with, and were impacted signifcantly by limb strength (r=0.78; p<0.01), hand function (r=0.65; p<0.01), visual perception (r=0.45; p<0.01), motor praxis (r=0.43; p<0.01), visuomotor organisation (r=0.48; p<0.01), and thinking operations (r=0.56; p<0.01). CONCLUSION: Motor, cognitive and perceptual impairments impacted activities and participation negatively. These impairments must be diagnosed and optimally managed. Key words: Stroke, cognition, perception, activities, participation

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“…While the three patients presented here were chosen because they reflect different change profiles, they share the general characteristics of large-scale studies, in that each patient shows preserved function in some tasks and multiple impairments across other tasks (Jaillard et al, 2009;Nys et al, 2007). Moreover, the precise profile of impaired and preserved tests differed from person to person.…”

Section: Discussionmentioning

confidence: 99%