Telephone interview for cognitive status-modified in study of cognitive impairment after cerebral ischemia

Abstract

Objective To study the variation characteristics of cognitive impairment and its influencing factors using telephone interview for cognitive status-modified(TICS-m)in patients after cerebral ischemia, and evaluate the application value of TICS-m. Methods Ninety-five patients with cerebral ischemia, matched the criteria and admitted to our hospital from December 2014 to December 2015, were chosen. Their related information was recorded, their cognitive function was assessed by face-to-face neuropsychological tests, including Montreal Cognitive Assessment(MoCA), Hamilton Depression Rating Scale, activities of daily living(ADL)and Chinese Neuropsychiatric Inventory(CNPI), in the acute stage(10-14 d), and then, their cognitive function was assessed by TICS-m 4, 12 and 18 weeks after cerebral ischemia and their rehabilitation was followed up. Results The incidence of cognitive impairment after cerebral ischemia in the acute stage was 78.9%; when cutoffs of dementia was <28 points and mild cognitive impairment(MCI)was 28-33 points in TICS-m, the incidences of cognitive impairment 4, 12 and 18 weeks after cerebral ischemia were 69.4%(MCI: 45.8%, dementia: 23.6%), 57.3%(MCI: 42.6%, dementia: 14.8%), 44.9%(MCI: 34.7%, dementia: 10.2%). And the TICS-m total scores 12 and 18 weeks after cerebral ischemia were significantly increased than that 4 weeks after cerebral ischemia, amplification reaching to 7.9% and 10.7%(P<0.05); subtests analysis indicated that 12 and 18 weeks after cerebral ischemia, the memory recovered obviously: the scores were significantly increased, amplification reaching to 34.5% and 49.0% as compared with those 4 weeks after the cerebral ischemia(P<0.05). Logistic regression analysis indicated that age(OR=66.615, P= 0.001, 95% CI: 5.449-814.349), education level(OR=0.134, P=0.009, 95% CI: 0.029-0.608)and work type(OR=0.090, P=0.004, 95%CI: 0.017-0.464)were closely related to the cognitive impairment after cerebral ischemia. The follow-up visit analysis showed that most patients(91.8%)could take the drug for the secondary prevention of stroke and return to the clinic regularly, and only a small part of patients(31.8%)took the related drugs to improve their cognitive impairment; about 77.6% patients recovered good after discharge, 54.7% patients supported and hoped the doctors continue the follow-up visit by telephone. Conclusions The incidence of cognitive impairment is high after cerebral ischemia and it declines over time, and advanced age, low education level and manual work are the important factors affect the incidence. TICS-m is an effective and convenient tool to assess the characteristic and prognosis of patients with cognitive impairment after the cerebral ischemia, and it' s suitable for clinic follow-up study and scientific research. Key words: Telephone interview for cognitive status-modified; Cerebral ischemia; Cognitive function