Very Early MoCA Can Predict Functional Dependence at 3 Months After Stroke: A Longitudinal, Cohort Study

Abzhandadze, Tamar; Rafsten, Lena; Nilsson, Åsa; Palstam, Annie; Sunnerhagen, Katharina S.

doi:10.3389/fneur.2019.01051

Cited by 38 publications

(38 citation statements)

References 31 publications

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“…We found that cognitive impairment was a significant explaining factor of ADL dependency 3 months after stroke, which is consistent with prior reports ( 9 , 33 ). Cognitive impairment is a common sequalae after stroke and can persist even after seemingly successful neurological recovery.…”

Section: Discussionsupporting

confidence: 93%

Dependency in Activities of Daily Living During the First Year After Stroke

et al. 2021

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Background: Dependency in personal activities of daily living (ADL) is a common short-term and long-term consequence of stroke and requires targeted rehabilitation. As the duration of hospital stay has become shorter in recent decades, early identification of patients who require rehabilitation has become vital. To our knowledge, no study has investigated whether ADL dependency in the very early stages after admission to the stroke unit can explain ADL dependency 3 and 12 months later. This knowledge would facilitate planning for very early discharge and patient-centered rehabilitation.Objective: This study evaluated whether ADL dependency within 2 days after stroke could explain ADL dependency at 3 and 12 months after stroke.Methods: This longitudinal cohort study included patients with stroke who were treated at a stroke unit in the Sahlgrenska University Hospital (Gothenburg, Sweden) between May 2011 and March 2016. The primary independent variable was ADL dependency at 36–48 h after admission to the stroke unit, which was assessed using a Barthel Index (BI) score of ≤90. The dependent variables were self-reported personal ADL dependency at 3 and 12 months after stroke. Binary logistic regression analyses were performed.Results: Of 366 eligible patients (58% male; median age 71 years), a majority (76%) had mild stroke and 60% were ADL dependent 36–48 h after stroke. Univariable and multivariable logistic regression analyses showed that patients who were dependent within the first 2 days after stroke had higher odds for being dependent 3 months as well as 12 months after stroke.Conclusion: The results indicated that dependency in personal ADL during the first 2 days can explain dependency at 3- and 12-month post-stroke. Therefore, early ADL assessments post-stroke can be used for understanding rehabilitation needs after stroke.

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Section: Discussionsupporting

confidence: 93%

Dependency in Activities of Daily Living During the First Year After Stroke

et al. 2021

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“…The SU was, at the time, the only hospital in Gothenburg performing thrombolysis and the only hospital in the Region Västra Götaland performing thrombectomy. Baseline data were merged with data in the Swedish national quality register for stroke care (Riksstroke) ( 20 , 21 ). The primary aim of Riksstroke is to gather data for the assessment of stroke care quality and rehabilitation at stroke units.…”

Section: Methodsmentioning

confidence: 99%

Predictors for self-reported feeling of depression three months after stroke: A longitudinal cohort study

Kaarre

Abzhandadze²,

Sunnerhagen³

2021

J Rehabil Med

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Objective Depression and impaired cognition are common consequences of stroke. The aim of this study was to determine whether cognitive impairment 36–48 h post-stroke could predict self-reported feeling of depression 3 months post-stroke. Design A longitudinal, cohort study. Patients Patients aged ≥ 18 years at stroke onset. Methods Cognition was screened using the Montreal Cognitive Assessment, 36–48 h after admission to the stroke unit at Sahlgrenska University Hospital. Information about self-reported feeling of depression 3 months post-stroke was retrieved from Riksstroke (the national quality register for stroke in Sweden). Bootstrapped binary logistic regression analyses were performed. Results Of 305 patients, 42% were female, median age was 70 years, and 65% had mild stroke. Three months post-stroke, 56% of patients had self-reported feeling of depression; of these, 65% were female. Impaired cognition at baseline could not predict self-reported feeling of depression 3 months later. The odds for self-reported feeling of depression were twice as high in female patients (odds ratio 2.01; 95% confidence interval, 0.20–1.22; p < 0.01). Conclusion Impaired cognition early after stroke could not predict self-reported feeling of depression 3 months post-stroke. Compared with male patients, female patients had twice the odds of self-reported feeling of depression LAY ABSTRACT Depression and impaired cognition are common consequences of stroke. This study investigated whether screening for cognitive function 36–48 h after stroke could predict self-reported feeling of depression 3 months later. Of the 305 patients with mild stroke, 56% had self-reported feeling of depression. Cognitive impairment could not predict self-reported feeling of depression. Therefore, cognitive screening within the first 2 days after stroke might be too early to predict self-reported feeling of depression 3 months after stroke. However, the high proportion of patients with self-reported feeling of depression indicates the severity of the problem that needs to be addressed.

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“…However, the prevalence of PSCI at 3 and 12 months after stroke was 29.4% and 36.8%, respectively, during the longitudinal follow-up. The reported prevalence varied among previous studies depending on divergent estimates of PSCI according to the population under study and the methods of de ning PSCI, suggesting a need for diagnosis criteria consensus (35,36).…”

Section: Discussionmentioning

confidence: 96%

Plasma Phosphorylated-tau181 is a Predictor of Post-Stroke Cognitive Impairment: A Longitudinal Study

Huang

Chao

et al. 2021

Preprint

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IntroductionPost-stroke cognitive impairment (PSCI) cannot be neglected because it drastically influences the daily life of patients and their families. However, there are no studies exploring the association between preclinical blood biomarkers of neurodegeneration including plasma amyloid-β (Aβ), tau and brain-derived neurotrophic factor (BDNF) together with the risk of PSCI. The present longitudinal study was to investigate whether these blood biomarkers with imaging markers of cerebral small vessel disease can improve the prediction for PSCI. In addition, we also explored the association between blood biomarkers with the trajectories of PSCI.MethodsAdult patients with first ever acute ischemic stroke were recruited, and the cognitive and functional abilities of these patients were evaluated. Furthermore, blood biomarkers of neurodegeneration including plasma Aβ-40, Aβ-42, total tau, phosphorylated tau 181 (p-tau181), and BDNF levels and image markers of cerebral small vessel disease were measured. Each patient was followed up at 3 and 12 months at the outpatient department.ResultsOf 136 patients, 40 and 50 patients developed PSCI at 3 and 12 months after stroke, respectively. In functional trajectories, 27 patients did not have PSCI at 3 months but did at 12 months. By contrast, the PSCI status of 17 patients at 3 months was reversed at 12 months. Patients with high acute plasma p-tau181 had a significantly lower PSCI risk at 3 months (odds ratio [OR] = 0.62, 95% confidence interval [CI] = 0.40–0.94, p = 0.0243) and 12 months (OR = 0.69, 95% CI = 0.47–0.99, p = 0.0443) after adjustment for covariates and image biomarkers. Discrimination and reclassification statistics indicated that the p-tau181 level can improve discrimination ability for PSCI at 3 and 12 months, respectively. Additionally, the plasma p-tau181 level was the highest in subjects without PSCI followed by those with delayed-onset PSCI and early-onset PSCI with reversal, whereas the lowest plasma p-tau181 level was found among those with persistent PSCI, showing a significant trend test (p = 0.0081).ConclusionsPlasma p-tau181 is a potential biomarker for predicting early- and delayed-onset PSCI. Future studies should incorporate plasma p-tau181 as indicator for timely cognitive intervention in the follow-up of patients with stroke.

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Very Early MoCA Can Predict Functional Dependence at 3 Months After Stroke: A Longitudinal, Cohort Study

Cited by 38 publications

References 31 publications

Dependency in Activities of Daily Living During the First Year After Stroke

Dependency in Activities of Daily Living During the First Year After Stroke

Predictors for self-reported feeling of depression three months after stroke: A longitudinal cohort study

Plasma Phosphorylated-tau181 is a Predictor of Post-Stroke Cognitive Impairment: A Longitudinal Study

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