Abstract

Background: There is paucity of data on the epidemiology of post-stroke cognitive impairment among African stroke survivors. The aim of this study is to report the profile and risk factors of post- stroke cognitive impairment among stroke survivors participating in the Stroke Investigative Research and Education Network (SIREN) Study. Methods: 1566 were evaluated with the Montreal Cognitive Assessment (MoCA) tool, the Community Screening Instrument for Dementia (CSID) and the Stick Design Test three months after the index stroke. Domain scores were derived for executive function, language memory and visuo-constructive/visuospatial domains. Cut off scores were derived from normative cognitive data obtained from comparable healthy stroke-free control subjects. We used conditional logistic regression to estimate odds ratios (OR) with 95% CIs. Results: Of 1566 stroke survivors [mean age 57.7 (13.4) years] who were assessed 3 months after stroke, 37% were impaired in global cognition and 18-43% were impaired in different domains of cognition (executive, memory, language and visuo-constructive). Stroke severity measured by modified NIHSS score had a strong significant negative association with cognitive function in all domains OR 1.96(1.32-2.91). Older age 1.04 (1.02-2.05), male gender 0.69 (0.50 -0.96), low intake of green leafy vegetables 2.83 (2.03 -3.95) and cardiac disease 1.86 (1.31 -2.75) were associated with poorer cognitive performance in different cognitive domains. Conclusion: The frequency of post-stroke cognitive impairment was high among African stroke survivors three months after the ictus. Diet low in green leafy vegetables is a potentially modifiable risk factor for post-stroke cognitive impairment among West Africans.

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