Profile of and risk factors for poststroke cognitive impairment in diverse ethnoregional groups

Jessica W. Lo , John D. Crawford , David W. Desmond , Olivier Godefroy (1) , Hanna Jokinen (2) , Simin Mahinrad , Hee-Joon Bae (3) , Jae-Sung Lim (3) , Sebastian Kohler (4) , Elles Douven , Julie Staals , Christopher Chen , Xin Xu , Eddie J. Chong , Rufus O. Akinyemi , Rajesh N. Kalaria , Adesola Ogunniyi (5) , Melanie Barbay (6) , Martine Roussel (1) , Byung-Chul Lee , Velandai K. Srikanth , Christopher Moran , Nagaendran Kandiah , Russell J. Chander , Behnam Sabayan (7) , J. Wouter Jukema (3) , Susanna Melkas (8) , Timo Erkinjuntti (9) , Henry Brodaty (10) , Regis Bordet (11) , Stephanie Bombois (12) , Hilde Henon (11) , Darren M. Lipnicki , Nicole A. Kochan , Perminder S. Sachdev (3) , Amy Brodtmann , Aleksandra Klimkowicz-Mrowiec (13) , Martin Dichgans (14) , Michael Hoffmann , Thomas Linden , Joanna Wardlaw (15) , Charlotte Cordonnier (11) , Vincent Mok (16)

1 LNFP - Laboratoire de Neurosciences Fonctionnelles et Pathologies - UR UPJV 4559
2 Helsingin yliopisto = Helsingfors universitet = University of Helsinki
3 Metacohorts Consortium
4 MUMC - Maastricht University Medical Centre
5 University of Ibadan
6 UPJV - Université de Picardie Jules Verne
7 HMS - Harvard Medical School [Boston]
8 Helsinki University Central Hospital
9 HUCH
10 UNSW - University of New South Wales [Sydney]
11 TCDV - Troubles cognitifs dégénératifs et vasculaires - U 1171
12 CHRU Lille - Centre Hospitalier Régional Universitaire [Lille]
13 UJ - Uniwersytet Jagielloński w Krakowie = Jagiellonian University
14 ISD - Institute for Stroke and Dementia Research
15 University of Edinburgh
16 Department of Medicine and Therapeutics [Hong Kong]

Objective To address the variability in prevalence estimates and inconsistencies in potential risk factors for poststroke cognitive impairment (PSCI) using a standardized approach and individual participant data (IPD) from international cohorts in the Stroke and Cognition Consortium (STROKOG) consortium. Methods We harmonized data from 13 studies based in 8 countries. Neuropsychological test scores 2 to 6 months after stroke or TIA and appropriate normative data were used to calculate standardized cognitive domain scores. Domain-specific impairment was based on percentile cutoffs from normative groups, and associations between domain scores and risk factors were examined with 1-stage IPD meta-analysis. Results In a combined sample of 3,146 participants admitted to hospital for stroke (97%) or TIA (3%), 44% were impaired in global cognition and 30% to 35% were impaired in individual domains 2 to 6 months after the index event. Diabetes mellitus and a history of stroke were strongly associated with poorer cognitive function after covariate adjustments; hypertension, smoking, and atrial fibrillation had weaker domain-specific associations. While there were no significant differences in domain impairment among ethnoracial groups, some interethnic differences were found in the effects of risk factors on cognition. Conclusions This study confirms the high prevalence of PSCI in diverse populations, highlights common risk factors, in particular diabetes mellitus, and points to ethnoracial differences that warrant attention in the development of prevention strategies.

Domaines: Sciences du Vivant [q-bio]

Jessica W. Lo, John D. Crawford, David W. Desmond, Olivier Godefroy, Hanna Jokinen, et al.. Profile of and risk factors for poststroke cognitive impairment in diverse ethnoregional groups. Neurology, 2019, 93 (24), pp.E2257-E2271. ⟨10.1212/WNL.0000000000008612⟩. ⟨hal-03606869⟩