University Hospital Alexandrovska; Clinic of Neurology; Sofia, Bulgaria
Title: The frequency of cognitive impairment and dementia one year after ischemic stroke in Bulgarian patients
Neli Petrova works as a neurologist in multi profile hospital for active treatment (MHAT) in Ruse, Bulgaria. She was Executive Director of the same hospital and is now chief of ward for functional diagnostic of nervous system. She has more than 20 years of experience in the field of: stroke, intensive treatment of cerebrovascular diseases, cognitive impairment and post-stroke dementia. She completed her PhD in September 2014 at the Medical University Sofia.
Introduction: Post-stroke cognitive impairment is frequent. There are, however, few longitudinal studies with controversial results examining delayed changes in cognition and predictive values of neuropsychological markers. Aim: The objective of this study was to determine the relative frequency of first-ever post-stroke dementia and cognitive impairments (one year after onset) in consecutive hospitalized patient. Methods: Eighty-five first-ever stroke inpatients (mean age 65.6±5.6) without previous cognitive complaints were prospectively evaluated with a comprehensive neuropsychological battery at 5th day, 1st, 6th and 12th. A wide range of demographic, clinical, radiological, and laboratory variables were examined. Results: At one year follow-up investigations, the results revealed 15 patients (20%) with no cognitive impairment (NCI), 30 patients (41%) with mild cognitive impairment (MCI) and 29 patients (39%) with dementia. From the dementia patients group, 4 patients improved their cognitive status - 3 patients to MCI level and one to NCI, and the others remained with dementia. From MCI patients group 27 patients remained MCI, 18 patients became demented, and 12 patients improved to NCI. Baseline impairments in attention/executive functions and memory, and hyppocampal atrophy were associated with development of dementia in post-stroke patients. Conclusion: Cognitive decline is common after stroke. Better knowledge of the neuropsychological markers in early phase of the disease and risk factors for delayed post-stroke dementia should increase the effectiveness of preventive strategies in patients with this condition.