| 제목 |
Factors Affecting Cognitive Score Decline Between 3 - 24months After Ischemic Stroke Patients. |
| 소속 |
Pusan National University Yangsan Hospital, Research Institute for Convergence of Biomedical Science and Technology1, Pusan National University Yangsan Hospital, Department of Rehabilitation Medicine2, Gyeongsang National University Hospital, Department of Statistics3, Yonsei University Sinchon Hospital, Department of Rehabilitation Medicine4, Chungnam National University Hospital, Department of Rehabilitation Medicine5, Konyang University Hospital, Department of Rehabilitation Medicine6, Chonnam National University Hospital, Department of Rehabilitation Medicine7, Kyungpook National University Medical Center, Department of Rehabilitation Medicine8, Wonkwang University School of Medicine & Hospital, Department of Rehabilitation Medicine9, Jeju National University Hospital, Department of Rehabilitation Medicine10, Hallym University Chuncheon, Department of Statistics11, Samsung Medical Center, Department of Rehabilitation Medicine12 |
| 저자 |
Eun Chae Lee1,2*, Ji Hong Min2, Seung Chan Kim3, Seong Hwa Ko2, Deog Young Kim4, Min Kyun Shon5, Jong Min Lee6, Yang Soo Lee7, Sam-Gyu Lee8, Min Cheol Joo9, Gyung-Jae Oh9, So young Lee10, Jun Hee Han11, Won Hyuk Chang12, Yong-Il Shin1,2†, Yun-Hee Kim12† |
Introduction
Our conducted a prospective study in conjunction with the Korean Stroke Cohort for Functioning and Rehabilitation (KOSCO). We analyzed the long-term cognitive changes from 3–24 months post stroke in patients. Further more, we identified risk factors to cognitive delays and cognitive disorders in patients from 3 to 24 months after an ischemic stroke.
Methods
Patients with ischemic stroke were divided into normal and disabled groups using the K-MMSE cut-off score. Patients were classified into two additional subgroups according to changes in cognitive scores between 3 and 24 months. Depending on the K-MMSE scores, patients with more than 24 points were classified as the normal cognition group(NCG) and those with less than 24 points were classified as the impaired cognition group(ICG). Patients with a drop of three points or more between 3 and 24 months were classified as the Least once R group, while patients with other score changes were classified as the Stable/Converter (SC) group.
In addition, functional evaluations other than initial medical records and cognitive function evaluations were analyzed for factors affecting cognitive changes in each group. functional evaluations were performed using face-to-face functional assessments, including the National Institutes of Health Stroke Scale NIHSS, mRS, FMA, FAC, K-FAST, ASHA-NOMS, K-MBI.
Results
Our study involved 2,561 patients with early ischemic stroke. The NCG (77%) and ICG (23%) groups were divided into two sub-groups (SC/SC, least once R).
During the 3–24 months of observation, the NCG-SC and ICG-SC groups maintained their cognitive scores, while the NCG-R and ICG-R groups showed a continuous decline and delay in cognitive scores during the screening period. Other factors significantly affected cognitive function in the NCG and ICG groups. The sub-groups showed significantly affected cognitive function 3–24 months after an ischemic stroke.
Discussion and Conclusion
Our study, the prevalence of cognitive impairment in cerebral infarction patients differed between 3, 12, and 24 months. The analysis of cognitive score trends over time showed a cognitive delay from 12 months. These delays can be seen as a therapeutic window for cognitive preservation after stroke.
By conducting post-hoc analyses, we could identify the predictors affecting cognitive delay. These findings may help in understanding the timing of cognitive therapy for future cerebral infarction patients and the pattern of cognitive function recovery. |
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Fig1. Cognitive function of ICG/NCG at 3 months to 24 months after stroke onset.
Table1. Quadratic Analysis of ICG / NCG and K-MMSE average scores to 3 month, 12 month and 24 months.
Fig2. Cognitive change of the ICG/NCG groups from 3months to 24months.
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