Abstract
BackgroundThe American Stroke Association/American Heart Association recommended the criteria for diagnosis of vascular cognitive impairment and memory impairment (MI) is a feature in the classification of vascular mild cognitive impairment (VaMCI). VaMCI patients with MI may differ in terms of infarct location or demographic features, so we evaluated the clinical characteristics associated with MI in patients with VaMCI.MethodsA prospective multicenter study enrolled 353 acute ischemic stroke patients who underwent evaluation using the Korean Vascular Cognitive Impairment Harmonization Standard Neuropsychological Protocol at three months after onset. The association between MI and demographic features, stroke risk factors, and infarct location was assessed.ResultsVaMCI was diagnosed in 141 patients, and 58 (41.1%) exhibited MI. Proportions of men and of left side infarcts were higher in VaMCI with MI than those without (75.9 vs. 57.8%, P = 0.03, 66.7 vs. 47%, P = 0.02). Multiple logistic analyses revealed that male sex (odds ratio [OR] 3.07, 95% confidence interval [95% CI] 1.12-8.42), left-side infarcts (OR 3.14, 95% CI 1.37-7.20), and basal ganglia/internal capsule infarcts (OR 4.53, 95% CI 1.55-13.22) were associated with MI after adjusting other demographic variables, vascular risk factors, and subtypes of stroke.ConclusionsMI is associated with sex and infarct location in VaMCI patients.
Highlights
The American Stroke Association/American Heart Association recommended the criteria for diagnosis of vascular cognitive impairment and memory impairment (MI) is a feature in the classification of vascular mild cognitive impairment (VaMCI)
The American Stroke Association/American Heart Association (ASA/AHA) recommended the following criteria for VaMCI: patient exhibits impairment in at least 1 of 4 cognitive domains; display normal or mild impairments in daily living activities; imaging results suggest cerebrovascular disease; a temporal relationship exists between the stroke and the cognitive symptoms
Hippocampal atrophy is generally not associated with vascular cognitive impairment (VCI) [13] and the correlation of MI with white matter hyperintensities, infarct location or laterality were reported after stroke, so the mechanisms of MI in VaMCI
Summary
Participants Six hundred twenty acute ischemic stroke patients from 12 hospitals were enrolled in the study within 7 days of symptom onset from October 2007 to August 2008. We conducted a baseline evaluation within two weeks of stroke onset to determine demographic characteristics, vascular risk factors, stroke subtype [18], and functional status. Among these 620 patients, 353 completed the 60-min K-VCIHS-NP evaluation at three months post-stroke. We administered the Korean version of the Informant Questionnaire on Cognitive Decline in the Elderly (K-IQCODE) to examine pre-morbid history of cognitive impairment; the Instrumental Activities of Daily Living scale (IADL) to assess instrumental complex daily functioning; and the Korean version of the Mini-Mental Status Examination (K-MMSE) and Clinical Dementia Rating (CDR) as supplementary tests of cognitive function at 3 months post-stroke. This study followed Good Clinical Practice guidelines and was consistent with the International Conference on Harmonization of ethical principles for medical research involving human subjects
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