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Post-stroke cognitive impairment (results of a 5-year follow-up)

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Prior stroke plays an important role in the development of cognitive impairment (CI), the prevention of which requires detailed study.

Patients and methods. A total of 350 patients (mean age, 65±17.7 years; 49% men) who had experienced a stroke with a small degree of neurological deficit were followed up. Cognitive functions were evaluated using the Mini-Mental State Examination (MMSE), Mattis dementia rating scale, the clock drawing test, the test on memorizing 12 words, and the Schulte table. During 5 years of follow-up, 61 (17.4%) patients died, including 45 (12.8%) from recurrent stroke; 89 recurrent strokes developed.

Results. The first examination did not reveal CI in 59 (17%) patients; 73 (21%) were found to have marked CI (mild or moderate dementia). After 1, 3, and 5years of follow-up, the proportion of patients with marked CI increased up to 23.2, 29.5, and 34.5%, respectively. Within 5 years, there was an average decline of 2 MMSE scores. The maximum decrease in cognitive functions was seen in patients who had experienced a recurrent stroke, but this also occurred in the absence of a stroke. Cognitive functions were substantially better in a group of patients with blood pressure (BP) normalization.

Conclusion. The 5-year follow-up has shown that post-stroke CI gradually progresses, which is associated with the progression of both vascular disease and a concomitant neurodegenerative process. BP normalization during antihypertensive therapy contributes to the prevention of progressive post-stroke CI. 

About the Authors

S. V. Verbitskaya
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

Department of Nervous System Diseases and Neurosurgery,

11, Rossolimo St., Moscow 119021

V. A. Parfenov
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

Department of Nervous System Diseases and Neurosurgery,

11, Rossolimo St., Moscow 119021

V. A. Reshetnikov
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

Department of Public Health and Health Care,

2, Bolshaya Pirogovskaya St., Moscow 119991

V. V. Kozlov
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

Department of Public Health and Health Care,

2, Bolshaya Pirogovskaya St., Moscow 119991

A. R. Kabaeva
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

Department of Nervous System Diseases and Neurosurgery,

11, Rossolimo St., Moscow 119021


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For citations:

Verbitskaya S.V., Parfenov V.A., Reshetnikov V.A., Kozlov V.V., Kabaeva A.R. Post-stroke cognitive impairment (results of a 5-year follow-up). Neurology, Neuropsychiatry, Psychosomatics. 2018;10(1):37-42. (In Russ.)

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ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)