Prevalence of cognitive impairment in acute ischaemic stroke and use of Alberta Stroke Programme Early CT Score (ASPECTS) for early prediction of post-stroke cognitive impairment.

Abstract

This study aims to assess the prevalence of post-stroke cognitive impairment, and to evaluate the correlation of ASPECTS with impaired cognition. 150 patients presenting with acute middle cerebral artery territory ischaemic stroke were included in this study. Risk factors of ischaemic stroke and the initial NIHSS were determined. An initial and a follow-up non-contrast CT brain were carried out after seven days which were assessed by ASPECTS. The prevalence of cognitive impairment was determined by MoCA during the follow up of patients after three months. Correlations of ASPECTS, NIHSS and MoCA were done by Spearman correlation. Multivariate logistic regression analysis was carried out for the independent variables of cognitive impairment. The prevalence of post-stroke cognitive impairment in this study, according to the threshold for cognitive impairment with a MoCA score of 25 or less, was 25.3% (38 patients). Significant positive correlations between ASPECTS and total MoCA test domains were found (r = 0.73 and P = 0.002). Logistic regression analysis demonstrated that the independent factors associated with cognitive impairment were older age, certain domains of the MoCA test like executive functions, memory, attention, language, NIHSS, HTN, and ASPECTS. There is a prevalence of cognitive impairment in about 25% of patients after three months of follow-up in cases with acute ischaemic stroke. ASPECTS is directly correlated with cognitive impairment, and may be considered as a biomarker of post-stroke cognitive impairment.