Stroke patients often experience motor deficits and cognitive problems after a stroke. Objective: To improve our understanding of the cognitive consequences of stroke. Method: a descriptive and analytical cross-sectional study was conducted over 12-month period in the neurology departments of the Cocody and Treichville Hospitals in C？te d’Ivoire. Results: Out of 724 patients admitted to the neurology department, 415 (57.32%) were stroke patients, of which 145 (34.94%) were screened. The frequency of global cognitive functioning impairment was 86.21%, significantly higher than the frequency of patients without impairment, which was 13.79%. The study focused on detailing the cognitive status of stroke patients in neurology departments, assessing several cognitive functions during the subacute phase of stroke. These functions included global cognitive functioning, executive functions, language and memory. The frequency of post-stroke cognitive impairment is high among stroke patients in Abidjan. This frequency is comparable to figures found in Subsaharian stroke populations. Demographic and clinical characteristics studied included age, gender, education level, employment status, vascular diseases and cerebral affected area. Among these characteristics, only the education level and the cerebral affected area have been found significant. Conclusion: The incidence of cognitive impairment after a stroke is significantly high among stroke patients in Abidjan.
References
[1]
Albakaye, M. (2010) Les accidents vasculaires cérébraux au mali: Étude des filières de prise en charge. Thèse Méd., FMOS, Bamako, No. 232, 113 p.
[2]
Esiri, M., Matthews, F., Brayne, C., Ince, P., Matthews, F. and Xuereb, J. (2001) Pathological Correlates of Late-Onset Dementia in a Multicentre, Community-Based Population in England and Wales. The Lancet, 357, 169-175.
[3]
Rockwood, K., Wentzel, C., Hachinski, V., Hogan, D.B., MacKnight, C. and McDowell, I. (2000) Prevalence and Outcomes of Vascular Cognitive Impairment. Vascular Cognitive Impairment Investigators of the Canadian Study of Health and Aging. Neurology, 54, 447-451. https://doi.org/10.1212/WNL.54.2.447
[4]
Saposnik, G., Cote, R., Rochon, P.A., Mamdani, M., Liu, Y. and Raptis, S. (2011) Care and Outcomes in Patients with Ischemic Stroke with and without Preexisting Dementia. Neurology, 77, 1664-1673. https://doi.org/10.1212/WNL.0b013e31823648f1
[5]
Patel, M., Coshall, C., Rudd, A.G. and Wolfe, C.D. (2003) Natural History of Cognitive Impairment after Stroke and Factors Associated with Its Recovery. Clinical Rehabilitation, 17, 158-166. https://doi.org/10.1191/0269215503cr596oa
[6]
Lesniak, M., Bak, T., Czepiel, W., Seniów, J. and Członkowska, A. (2008) Frequency and Prognostic Value of Cognitive Disorders in Stroke Patients. Dementia and Geriatric Cognitive Disorders, 26, 356-363. https://doi.org/10.1159/000162262
[7]
Jacova, C., Pearce, L.A., Costello, R., McClure, L.A., Holliday, S.L. and Hart, R.G. (2012) Cognitive Impairment in Lacunar Strokes: The SPS3 Trial. Annals of Neurology, 72, 351-362. https://doi.org/10.1002/ana.23733
[8]
Whiting, D.R., Hayes, L. and Unwin N.C. (2003) Diabetes in Africa. Challenges to Health Care for Diabetes in Africa. Journal of Cardiovascular Risk, 10, 103-110. https://doi.org/10.1177/174182670301000205
[9]
Jorm, A. and Jacomb, P. (1989) The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE): Socio-Demographic Correlates, Reliability, Validity and Some Norms. Psychological Medicine, 19, 1015-1022. https://doi.org/10.1017/S0033291700005742
[10]
Nasreddine, Z.S., Phillips, N.A., BÉDirian, V., Charbonneau, S., Whitehead, V. and Collin, I. (2005) The Montreal Cognitive Assessment, MoCA: A Brief Screening Tool for Mild Cognitive Impairment. Journal of the American Geriatrics Society, 53, 695-699. https://doi.org/10.1111/j.1532-5415.2005.53221.x
[11]
Dubois, B., Slachevsky, A., Litvan, I. and Pillon, B. (2000) The FAB: A Frontal Assessment Battery at Bedside. Neurology, 55, 1621-1626. https://doi.org/10.1212/WNL.55.11.1621
[12]
Flamand-Roze, C., Falissard, B., Roze, E., Maintigneux, L., Beziz, J., Chacon, A., JoinLambert, C., Adams, D. and Denier, C. (2011) Validation of a New Language-Screening Tool for Patients with Acute Stroke: The Language Screening Test (LAST). Stroke, 42, 1224-1229. https://doi.org/10.1161/STROKEAHA.110.609503
[13]
Blackburn, H.L. and Benton, A.L. (1957) Revised Administration and Scoring of the Digit Span Test. Journal of Consulting Psychology, 21, 139-143. https://doi.org/10.1037/h0047235
[14]
Vidović, M., Sinanović, O., Sabaskić, L., Haticić, A. and Brkić, E. (2011) Incidence and Types of Speech Disorders in Stroke Patients. Acta Clinica Croatica, 50, 491-494.
[15]
Cullen, B., O’Neill, B., Evans, J.J., Coen, R.F. and Lawlor, B.A.A. (2007) Review of Screening Tests for Cognitive Impairment. Journal of Neurology, Neurosurgery, and Psychiatry, 78, 790-799. https://doi.org/10.1136/jnnp.2006.095414
[16]
Burton, L. and Tyson, S.F. (2015) Screening for Cognitive Impairment after Stroke: A Systematic Review of Psychometric Properties and Clinical Utility. Journal of Rehabilitation Medicine, 47, 193-203. https://doi.org/10.2340/16501977-1930
[17]
Tu, Q.Y., Yang, X., Ding, B.R., Jin, H., Lei, Z.H. and Bai, S. (2011) Epidemiological Investigation of Vascular Cognitive Impairment Post Ischemic Stroke. Chinese Journal of Gerontology, 31, 3576-3579.
[18]
Mukhopadhyay, A., Sundar, U., Adwani, S. and Pandit, D. (2012) Prevalence of Stroke and Post-Stroke Cognitive Impairment in the Elderly in Dharavi, Mumbai. Journal of the Association of Physicians of India, 60, 29-32.
[19]
Qu, Y., Zhuo, L., Li, N., Hu, Y., Chen, W. and Zhou, Y. (2015) Prevalence of Post-Stroke Cognitive Impairment in China: A Community-Based, Cross-Sectional Study. PLOS ONE, 10, e0122864. https://doi.org/10.1371/journal.pone.0122864
[20]
Pinzon, R.T., Rosa, D.S. and Satrianti, T. (2018) The Prevalence and Determinant Factors of Post-Stroke Cognitive Impairment. Asian Pacific Journal of Health Sciences, 5, 78-83. https://doi.org/10.21276/apjhs.2018.5.1.17
[21]
Jokinen, H., Melkas, S., Ylikoski, R., Pohjasvaara, T., Kaste, M., Erkinjuntti, T. and Hietanen, M. (2015) Post-Stroke Cognitive Impairment Is Common Even after Successful Clinical Recovery. Journal Européen de Neurologie, 22, 1288-1294. https://doi.org/10.1111/ene.12743
[22]
Sarfo, F.S., Akassi, J., Adamu, S., Obese, V. and Ovbiagele, B. (2017) Fardeau et prédicteurs des troubles cognitifs post-avc chez un échantillon de survivants ghanéens d’un avc. Journal des accidents vasculaires cérébraux et des maladies cérébrovasculaires: Le journal officiel de la national stroke association, 26, 2553-2562.
[23]
Akinyemi, R.O., Allan, L., Owolabi, M.O., Akinyemi, J.O., Ogbole, G., Ajani, A., Firbank, M., Ogunniyi, A. and Kalaria, R.N. (2014) Profil et déterminants de la déficience cognitive vasculaire chez les survivants africains d’un avc: L’étude cogfast nigeria. Journal of the Neurological Sciences, 346, 241-249. https://doi.org/10.1016/j.jns.2014.08.042
[24]
Kaddumukasa, M.N., Kaddumukasa, M.K.E., Sewankambo, N.L., Namujju, D. and Goldstein, L.B. (2023) Prévalence et prédicteurs des troubles cognitifs post-avc chez les survivants d’un avc en ouganda. BMC Neurology, 23, Article No. 166. https://doi.org/10.1186/s12883-023-03212-8
[25]
Wagle, J., Farner, L. and Flekkøy, K. (2011) Early Post-Stroke Cognition in Stroke Rehabilitation Patients Predicts Functional Outcome at 13 Months. Dementia and Geriatric Cognitive Disorders, 31, 379-387. https://doi.org/10.1159/000328970
[26]
Lees, R., Stott, D.J., Quinn, T.J. and Broomfield, N.M. (2014) Feasibility and Diagnostic Accuracy of Early Mood Screening to Diagnose Persisting Clinical Depression/Anxiety Disorder after Stroke. Cerebrovascular Diseases, 37, 323-329. https://doi.org/10.1159/000360755
[27]
Hachinski, V.C., Iliff, L.D., Zilhka, E., Du Boulay, G.H., McAllister, V.L. and Marshall, J. (1975) Cerebral Blood Flow in Dementia. Archives of Neurology, 32, 632-637. https://doi.org/10.1001/archneur.1975.00490510088009
[28]
Zhao, S., Guo, C., Wang, M., Chen, W., Wu, Y. and Tang, W. (2011) A Clinical Memory Battery for Screening for Amnestic Mild Cognitive Impairment in an Elderly Chinese Population. The American Journal of Geriatric Pharmacotherapy, 18, 774-779. https://doi.org/10.1016/j.jocn.2010.07.149
[29]
Gorelick, P.B., Scuteri, A. and Black, S.E. (2011) Vascular Contributions to Cognitive Impairment and Dementia: A Statement for Healthcare Professionals from the American Heart Association/American Stroke Association. Stroke, 42, 2672-2713. https://doi.org/10.1161/STR.0b013e3182299496
[30]
Wang, J., Xiao, L.D., Wang, K., Luo, Y. and Li, X. (2020) Déficience cognitive et facteurs associés chez les personnes âgées rurales du nord de la chine. Journal of Alzheimer’s Disease, 77, 1241-1253. https://doi.org/10.3233/JAD-200404
[31]
El-Sheik, W.M., El-Emam, A.I., El-Rahman, A. and Salim, G.M. (2021) Prédicteurs de démence après un premier accident vasculaire cérébral ischémique. Dementia & Neuropsychologia, 15, 216-222. https://doi.org/10.1590/1980-57642021dn15-020009
[32]
Tang, W.K. and Chan, H.F.K. (2006) Frequency and Clinical Determinants of Poststroke Cognitive Impairment in Nondemented Stroke Patients. Journal of Geriatric Psychiatry and Neurology, 19, 65-71. https://doi.org/10.1177/0891988706286230
[33]
Stern, Y. (2009) Réserve Cognitive. Neuropsychologie, 47, 2015-2028. https://doi.org/10.1016/j.neuropsychologia.2009.03.004
[34]
Chen, X.D., Han, L., Tian, Y., Dai, L. and Wang, Q. (2016) Prédicteurs de déficience cognitive vasculaire chez les patients victimes d’un AVC. Neurologie BMC, 16, Article No. 115. https://doi.org/10.1186/s12883-016-0638-8
[35]
Singh-Manoux, A., Marmot, M.G. and Glymour, M. (2011) Does Cognitive Reserve Shape Cognitive Decline? Annals of Neurology, 70, 296-304. https://doi.org/10.1002/ana.22391
[36]
Zahodne, L.B., Glymour, M.M. and Sparks, C. (2011) Education Does Not Slow Cognitive Decline with Aging: 12-Year Evidence from the Victoria Longitudinal Study. Journal of the International Neuropsychological Society, 17, 1039-1046. https://doi.org/10.1017/S1355617711001044
[37]
Elbaz, A., Vicente-Vytopilova, P. and Tavernier, B. (2013) Motor Function in the Elderly: Evidence for the Reserve Hypothesis. Neurology, 81, 417-426. https://doi.org/10.1212/WNL.0b013e31829d8761
[38]
Douiri, A., Rudd, A.G. and Wolfe, C.D. (2013) Prevalence of Poststroke Cognitive Impairment: South London Stroke Register 1995-2010. Stroke, 44, 138-145. https://doi.org/10.1161/STROKEAHA.112.670844
[39]
Khedr, E.M., Hamed, H.K. and El-Shereef (2009) Cognitive Impairment after Cerebrovascular Stroke: Relationship to Vascular Risk Factors. Neuropsychiatric Disease and Treatment, 5, 103-116. https://doi.org/10.2147/NDT.S4184
[40]
Munsch, F., Sagnier, S., Asselineau, J., Bigourdan, A., Guttmann, C.R. and Debruxelles, S. (2016) Stroke Location Is an Independent Predictor of Cognitive Outcome. Stroke, 47, 66-73. https://doi.org/10.1161/STROKEAHA.115.011242
