Uncovering Post-stroke Cognitive Impairment: A Retrospective Analysis at the University of Oklahoma Vascular Neurology Service
Jennifer Swinton1, Camila Bonin Pinto2, Ana Luyza Oliveira Santos3, Cameron Owens3, Cheyenne Gutierrez4, Blair Apple Hill3, Kate Singleton4, Zyanna Stuart4, Andriy Yabluchanskiy3, Faddi Saleh Velez5
1Neurology, University of Oklahoma College of Medicine, 2Geroscience Lab, University of Oklahoma, 3University of Oklahoma, 4OU Health, 5University of oklahoma health Sciences center
Objective:
To characterize the incidence of post-stroke cognitive impairment (PSCI) and assess underlying characteristics that can lead to early and more severe presentation.
Background:
Stroke is the leading cause of death and long-term disability in the United States. While advancements in acute stroke treatments have significantly improved survival and functional outcomes, up to 60% of stroke survivors develop PSCI in the first year after stroke. Of these, 80% of individuals never return to pre-stroke cognitive levels. increasing the risk of disability, mortality, and burdens the healthcare system and society. Therefore, it is essential to identify cognitive impairment early after stroke to appropriately address the needs of these patients.
Design/Methods:
In this single center retrospective chart review, cognitive decline in post-stroke patients was assessed by the Montreal Cognitive Assessment (MoCA) at discharge. Utilizing a multivariate regression model, factors associated with the development of PSCI were identified.
Results:
We reviewed 964 stroke patients charts and identified 294 MoCA scores from June 2022 to July 2023 (195 ischemic, 57 hemorrhagic, 42 subarachnoid hemorrhages, average age 62.17 ± 15.33). In 86.4% of the cases MoCA was below 26 indicating at least mild cognitive impairment. Older age is associated with lower MoCA scores, but only statistically significant for ischemic etiology (r= -.13,p<0.05). Average MoCAs were 19.1 for ischemic strokes, 18.4 for intracerebral hemorrhages, 19.7 for subarachnoid hemorrhages, and 23.0 for strokes not otherwise specified.
Conclusions:
This study underscores the high prevalence of PSCI in our cohort; further steps will allow us to pinpoint anatomical traits that contribute to early and severe PSCI. Larger studies are necessary to better identify patient characteristics and factors associated with PSCI. Targeting these individuals will enhance rehabilitation, independence, and quality of life through tailored support and resources.