A prospective cohort study on longitudinal trajectories of cognitive function after stroke

Dongni Buvarp,Katharina S Sunnerhagen,Tamar Abzhandadze,Lena Rafsten

doi:10.1038/s41598-021-96347-y

Dongni Buvarp, Katharina S Sunnerhagen + Show 2 more

Open Access

https://doi.org/10.1038/s41598-021-96347-y

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Abstract

The study aimed to determine longitudinal trajectories of cognitive function during the first year after stroke. The Montreal Cognitive Assessment (MoCA) was used to screen cognitive function at 36–48 h, 3-months, and 12-months post-stroke. Individuals who shared similar trajectories were classified by applying the group-based trajectory models. Data from 94 patients were included in the analysis. Three cognitive functioning groups were identified by the trajectory models: high [14 patients (15%)], medium [58 (62%)] and low [22 (23%)]. For the high and medium groups, cognitive function improved at 12 months, but this did not occur in the low group. After age, sex and education matching to the normative MoCA from the Swedish population, 52 patients (55%) were found to be cognitively impaired at baseline, and few patients had recovered at 12 months. The impact on memory differs between cognitive functioning groups, whereas the impact on activities of daily living was not different. Patients with the poorest cognitive function did not improve at one-year poststroke and were prone to severe memory problems. These findings may help to increase focus on long-term rehabilitation plans for those patients, and more accurately assess their needs and difficulties experienced in daily living.

Highlights

The study aimed to determine longitudinal trajectories of cognitive function during the first year after stroke
There was a significant increase in Montreal Cognitive Assessment (MoCA) scores of the whole study sample at 3 months [improved 2 scores; standardized β, 0.36, adjusted p < 0.001], as well as at 12-months post-stroke [improved 3 scores; standardised β, 0.37, adjusted p < 0.001], after adjustment for age and sex
Patients with age ≥ 75 years had poorer cognition over time [odds ratio (OR), 0.66, p = 0.02]

Summary

Introduction

The study aimed to determine longitudinal trajectories of cognitive function during the first year after stroke. The risk of post-stroke dementia may likely be related to the incidence of stroke rather than to the background vascular risk factors1 To date, it remains unclear how the longitudinal progress of post-stroke cognition varies in patients with different degrees of cognitive functioning in the acute phase. It is not clear when this cognitive decline will occur It is unknown if patients with varying baseline degrees of cognition will share similar trajectories over time. Exploring these longitudinal trajectories is, warranted to enhance understanding of the recovery of cognitive function post-stroke while deciphering the heterogeneity. The study aimed to identify trajectories of cognition during the first year after stroke, and to examine the impact of different trajectory groups in relation to memory performance and activities of daily living

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