Objective: To evaluate cognitive outcome in adult survivors of bacterial meningitis.
Methods: Data from three prospective multicentre studies were pooled and reanalysed, involving 155 adults surviving bacterial meningitis (79 after pneumococcal and 76 after meningococcal meningitis) and 72 healthy controls.
Results: Cognitive impairment was found in 32% of patients and this proportion was similar for survivors of pneumococcal and meningococcal meningitis. Survivors of pneumococcal meningitis performed worse on memory tasks (p<0.001) and tended to be cognitively slower than survivors of meningococcal meningitis (p = 0.08). We found a diffuse pattern of cognitive impairment in which cognitive speed played the most important role. Cognitive performance was not related to time since meningitis; however, there was a positive association between time since meningitis and self-reported physical impairment (p<0.01). The frequency of cognitive impairment and the numbers of abnormal test results for patients with and without adjunctive dexamethasone were similar.
Conclusions: Adult survivors of bacterial meningitis are at risk of cognitive impairment, which consists mainly of cognitive slowness. The loss of cognitive speed is stable over time after bacterial meningitis; however, there is a significant improvement in subjective physical impairment in the years after bacterial meningitis. The use of dexamethasone was not associated with cognitive impairment.
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Funding: This study was supported by a grant from the Meningitis Research Foundation, UK (DvdB grant No 03/03). The Dutch Meningitis Cohort was supported in part by an unrestricted research grant from Roche Pharmaceuticals (JdG). The European Dexamethasone Study was supported in part by a research grant from Organon NV (JdG). DvdB is supported by personal grants from the Netherlands Organisation for Health Research and Development (ZonMw) (NWO-Veni grant 2006 (916.76.023), NWO-Rubicon grant 2006 (019.2006.1.310.001)) and the Dr Jan Meerwaldt Foundation. MH, MW and BS have received no specific funding for this study.
Competing interests: None.
- European Dexamethasone Study
- Groningen Intelligence Test
- Glasgow Outcome Scale
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