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首页> 外文期刊>Frontiers in Neurology >Association Between Early Cognitive Impairment and Midterm Functional Outcomes Among Chinese Acute Ischemic Stroke Patients: A Longitudinal Study
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Association Between Early Cognitive Impairment and Midterm Functional Outcomes Among Chinese Acute Ischemic Stroke Patients: A Longitudinal Study

机译：早期认知障碍与中期功能成果与中医缺血性卒中患者中的关联：纵向研究

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Background: Cognitive decline is common after stroke. The influence of early cognitive impairment on midterm functional outcomes among Chinese acute ischemic stroke (AIS) patients has not been fully studied. The aim of the study was to assess the association between early cognitive impairment and midterm functional outcomes among Chinese AIS patients. Methods: A longitudinal survey focusing on Chinese AIS patients was conducted in three stroke centers in Shanghai, China (July to December 2016). A total of 185 eligible patients were interviewed at acute stage and at 1, 3, and 6 months after onset. Patients' functional outcomes were measured by modified Rankin Scale (mRS) and Barthel Index (BI) at each time point. Cognitive function was assessed using Montreal Cognitive Assessment, Changsha version (MoCA-CS), within 7 days after stroke onset. Covariates included patient's demographic characteristics, socioeconomic status, clinical characteristics of stroke, vascular risk factors, receiving rehabilitation after discharge from acute hospital, and recurrence. Generalized linear mixed models and general linear mixed models were applied. Results: The prevalence of cognitive impairment at acute stage of stroke among these patients was 88.1%. The risk of disability (mRS 2–5) of all patients after stroke decreased over time (OR = 0.491, 95% CI = 0.401–0.603). The risk of disability among those with cognitive impairment increased compared with those with normal cognition (OR = 7.384, 95% CI = 1.041–52.407). The BI score of all patients increased over time after controlling for covariates (β = 1.51, p & 0.01). The BI score of those with cognitive impairment was lower than that with normal cognition over the follow-up period after controlling for other covariates (β = ?8.11, p & 0.05). Conclusions: This study showed that early cognitive impairment was associated with higher risk of disability and poor activity of daily living (ADL) among Chinese AIS patients. Further studies are needed to examine the linkage between multi-domain cognitive impairment and long-term disability and ADL among stroke survivors by using neuropsychological test batteries.
机译：背景：中风后认知下降是常见的。早期认知损伤对中药缺血性卒中（AIS）患者中期功能结果的影响尚未得到充分研究。该研究的目的是评估中国AIS患者的早期认知障碍和中期功能结果之间的关联。方法：在中国上海的三冲程中心（7月至2016年12月），在中国AIS患者上进行了纵向调查。共有185名符合条件的患者在急性阶段和发病后的1,3和6个月内接受采访。通过在每个时间点进行改性的Rankin Scale（MRS）和Barthel指数（BI）测量患者的功能结果。使用蒙特利尔认知评估，长沙版（MOCA-CS）进行评估认知功能，在卒中发作后7天内。协变量包括患者的人口统计特征，社会经济状况，中风，血管危险因素，从急性医院排出后接受康复，再次发生。施加了广义的线性混合模型和一般线性混合模型。结果：这些患者中风中急性阶段的认知障碍患病率为88.1％。随着时间的推移（或= 0.491,95％CI = 0.401-0.603），所有患者的残疾风险（2-5夫人）的风险降低（或= 0.491,95％CI = 0.401-0.603）。与具有正常认知的人（或= 7.384,95％CI = 1.041-52.407）相比，具有认知障碍的残疾风险增加。所有患者的BI得分随着时间的推移而增加，控制协变量（β= 1.51，P <0.01）。具有认知障碍的双重成绩低于控制其他协变量（β=β.8.11，P <0.05）后对随访期间的正常认知。结论：本研究表明，早期的认知障碍与中国AIS患者中的患者残疾风险较高，日常生活（ADL）的风险较高。需要进一步的研究来通过使用神经心理学测试电池来检查多域认知损伤和长期残疾和长期残疾和ADL之间的联系。

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