In two-thirds of cases, PSCI corresponds to a mild cognitive impairment, in one third to dementia and significantly impacts the quality of life of stroke survivors. In collective perception as well as in clinical trials, disability after stroke is mainly intended as physical disability, although a broader vision that includes evaluation of cognitive impairment is recommended because more than half of stroke survivors experience post-stroke cognitive impairment (PSCI). The major burden of stroke concerns the chronic phase. Stroke is the second leading cause of death and the third leading cause of disability worldwide. ConclusionĪ bedside cognitive screening with the CDT helps identifying patients at higher risk of PSCI. A pathological baseline score on MoCA-B (< 24) did not predict increased risk of cognitive decline at follow-up nor increased predictivity of stand-alone CDT. In multi-adjusted (for age, education, comorbidities score, NIHSS at admission and atrophy score) model, a pathological score on baseline CDT (< 6.55) was associated with a higher risk of PSCI at follow-up (HR 2.022 95% CI 1.025–3.989, p < 0.05) with respect to non-pathological scores. ![]() In comparison with patients who remained cognitively stable at follow-up, these patients were older, less educated, had more comorbidities, a higher score on the National Institutes of Health Stroke Scale (NIHSS) at admission, more severe cerebral atrophy, and lower MoCA-B and CDT scores at baseline. At follow-up (mean duration ± SD 12.8 ± 8.7 months), 28 (18.9%) incident cases of MCI and 27 (18%) cases of dementia were recorded. Out of 191 stroke survivors who were non-demented at baseline, 168 attended at least one follow-up visit. MethodsĪ cognitive assessment within a few days of ischemic or hemorrhagic stroke was performed in patients consecutively admitted to a stroke unit over 14 months by means of the Clock Drawing Test (CDT) and the Montreal Cognitive Assessment-Basic (MoCA-B). ![]() We aimed to determine the predictivity of two screening cognitive tests on the occurrence of mild cognitive impairment or dementia in acute stroke patients. The early detection of patients at risk of post-stroke cognitive impairment (PSCI) may help planning subacute and long-term care.
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