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1 Research Institute Brain and Behaviour, Department of Psychiatry and Neuropsychology, University of Maastricht/University Hospital Maastricht, Maastricht, the Netherlands
2 Research Institute Brain and Behaviour, Department of Neurology, University of Maastricht/University Hospital Maastricht, Maastricht, the Netherlands
Correspondence to:
Correspondence to:
Dr J Lodder
Department Neurology, PO Box 5800, 6200 MD Maastricht, the Netherlands; jlod{at}sneu.azm.nl
Objective: Little is known about the relation between stroke related features and cognitive performance over time when stroke patients with dementia or less severe cognitive disorders are considered separately. We aimed to study the features (computed tomography (CT) scan and demographic) that could be related to vascular cognitive impairment one, six, and 12 months after stroke.
Methods: A total of 176 patients with a first-ever brain infarct, a Mini Mental State Examination score 
15, age older than 40 years, and without pre-stroke dementia and other neurological or psychiatric disorders participated in this study. The following CT scan features were recorded: side of infarct, lacunar or territorial infarct, white matter lesions, silent infarcts, and brain atrophy. The demographic features studied were: age, level of education, and sex. Univariate and multivariate logistic regression analyses were performed to compare the three groups of patients (patients with dementia, patients with vascular cognitive impairment (VCI), and patients with vascular mild cognitive impairment (MCI)) with patients without cognitive disorders.
Results: At one month none of the variables were predictors of dementia; at six months older age (odds ratio (OR) 9.4), low education (OR 14.7), and territorial infarct (OR 10.6) predicted dementia; and at 12 months low education (OR 8.7) and pre-stroke cerebrovascular damage (OR 7.4) predicted dementia. Predictors of VCI were low education (OR 3.4) and territorial infarct (OR 2.4) at one month post stroke; older age (OR 4.3) and low education (OR 4.1) at six months; and older age (OR 3.5) at 12 months. Predictors of vascular MCI were low education (OR 4.96) and territorial infarct (OR 3.58) at one month; and older age and lower education at six months (OR 3.4 and 3.7, respectively) and at 12 months (OR 3.5 and 2.28, respectively).
Conclusions: Territorial infarct, older age, and low educational level are predictors of cognitive disorders after stroke.
Abbreviations: CODAS, COgnitive Disorders After Stroke; CI, confidence interval; CT, computed tomography; MCI, mild cognitive impairment; MMSE, Mini Mental State Examination; OR, odds ratio; VaD, vascular dementia; VCI, vascular cognitive impairment
Keywords: stroke; vascular cognitive disorders; CT
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