Abstract

Background: Stroke is a leading cause of adult disability and mortality worldwide. Beyond motor and sensory deficits, cognitive dysfunction after stroke substantially affects independence and rehabilitation. Timely detection of post-stroke cognitive impairment (PSCI) allows early intervention. The present study assessed neurocognitive functions in post-acute stroke patients who underwent endovascular or decompressive surgical intervention and compared them with healthy controls using the Addenbrooke’s Cognitive Examination III (ACE-III). Methods: This hospital-based observational case–control study included 40 consecutive patients (18–80 years) with first-ever acute stroke (< 7 days) admitted to the Neurosciences Department, Santokba Durlabhji Memorial Hospital, Jaipur, and 40 age and sex-matched healthy controls. Cases underwent endovascular thrombectomy, aneurysm coiling, clipping, or decompressive craniectomy. Cognitive performance was evaluated at 3 and 6 months using the Hindi-adapted ACEIII assessing five domains attention/orientation, memory, fluency, language, and visuospatial abilities. Statistical analysis used SPSS v22; p < 0.05 was considered significant. Results: Mean patient age was 58.6 ± 11.2 years; 60%were male. Ischemic stroke comprised 72.5%of cases and haemorrhagic 27.5%. Hypertension (42.5%) and diabetes (27.5%) were the most frequent comorbidities. At 3 months, 72.5%of patients demonstrated cognitive impairment versus 62.5%at 6 months. Total ACE-III scores improved from 60.9 ± 10.9 to 74.5 ± 10.7 (p < 0.001). Memory and language domains were most affected initially. Cognitive outcomes did not differ significantly by stroke subtype.

• 1.   Feigin VL et al. Global burden of stroke and risk factors, 1990-2019. Lancet Neurol. 2021;20(10):795-820.
• 2.   World Health Organization. Definition and diagnosis of stroke. Geneva: WHO; 2010.
• 3.   GBD Stroke Collaborators. Global, regional, and national burden of stroke. Lancet Neurol. 2021;20:913-924.
• 4.   Pendlebury ST, Rothwell PM. Prevalence, incidence, and factors associated with PSCI. Stroke. 2019;50:161-169.
• 5.   Sexton E et al. Cognitive impairment after stroke: systematic review. Age Ageing. 2019;48:134-140.
• 6.   Gottesman RF et al. Cognitive impairment after stroke. Stroke. 2016;47:1316-1322.
• 7.   Visser MM. Emotional and cognitive consequences of stroke. Neuropsychol Rev. 2002;12:145-158.
• 8.   Mijajlovic MD et al. Post-stroke dementia: comprehensive review. BMC Med. 2017;15:11.
• 9.   Pendlebury ST et al. Cognitive decline trajectories after stroke. Cerebrovasc Dis. 2018;45:1-13. 10. Pandian JD et al. Stroke epidemiology in India. Int J Stroke. 2022;17(6):650-658.
• 11.   Nasreddine ZS et al. The Montreal Cognitive Assessment, MoCA. J Am Geriatr Soc. 2005;53:695-699.
• 12.   Hsieh S et al. The Addenbrooke’s Cognitive Examination-III: psychometric validation. Neurology. 2013;81:102-108.
• 13.   Tham W et al. Cognitive trajectory after stroke. J Neurol Sci. 2015;357:318-324.
• 14.   Chaurasia RN et al. Cognitive impairment following stroke in Indian population. J Neurosci Rural Pract. 2020;11:203-210.
• 15.   Renjen PN et al. Cognitive impairment after first-ever ischemic stroke. Ann Indian Acad Neurol. 2015;18:323-326.
• 16.   Fiedorová M et al. Addenbrooke’s Cognitive Examination in stroke. J Clin Med. 2019; 8:1612.
• 17.   Stern Y. Cognitive reserve and brain maintenance. Lancet Neurol. 2012;11: 1006-1012.

Data Sharing Statement

Funding