Clinical characteristics and related factors of cognitive impairment in elderly post-stroke aphasia patients

Abstract

Objective To explore the clinical characteristics and related factors of cognitive impairment in elderly post-stroke aphasia(PSA)patients. Methods Eighty-two patients after stroke, admitted to our hospitals between April 2013 and November 2014, were enrolled in this study, including 62 patients with aphasia. Based on the criteria for age segmentation from World population ageing 2009[6], these patients were divided into 3 groups with age=60 years: PSA patients older than 60 years as experimental group(n=30), PSA patients younger than 60 years as control group I(n=32), and non-aphasia patients older than 60 years as control group II(n=20). The clinical data, NIHSS scores and MRI/CT results of these patients were recorded; and the assessments of language ability, post-stroke depression(PSD)and nonlinguistic cognition were performed; classification of aphasia severity of the patients was performed by Boston diagnostic aphasia examination(BDAE). Multivariate regression analysis was performed to examine relative factors of cognitive impairment in PSA patients. Results (1)Nonlinguistic cognitive scores were significantly correlated with BDAE scores(β=0.637, P=0.000), age(β =-0.392, P=0.000), SADQ-H scores(β =-0.176, P=0.035)and cortical lesions(β =-0.150, P= 0.049).(2)As compared with patients of control group I, patients of experimental group were more likely showed deficits in most nonlinguistic cognitive domains except for abstract reasoning; and the cognitive function scale scores were significantly decreased(P<0.05); patients of experimental group had significantly increased number of nonlinguistic cognitive domains and significantly decreased cognitive function scale scores, except for visual perception and construction scores as compared with patients of control group II(P<0.05).(3)The prevalence of abstract reasoning impairment was significantly lower as compared with that of visual memory, attention and executive functioning in patients of experimental group(P<0.05).(4)The frequency and severity of impaired cognitive domains in the experiment group were significantly higher than those in the control group I and II(P<0.05). Conclusions Nonlinguistic cognitive impairment is extremely common in elderly PSA patients. The aphasia severity and age are most associated with cognitive impairment in PSA patients, post-stroke depression and cortical lesions also have an effect on cognitive scores. Key words: Post-stroke aphasia; The elderly; Cognitive disorder; Clinical determinant