Profile of and risk factors for poststroke cognitive impairment in diverse ethnoregional groups

Stroke and Cognition (STROKOG) Collaboration

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To address the variability in prevalence estimates and inconsistencies in potential risk factors for poststroke cognitive impairment (PSCI) using a standardized approach and individual participant data (IPD) from international cohorts in the Stroke and Cognition Consortium (STROKOG) consortium. METHODS: We harmonized data from 13 studies based in 8 countries. Neuropsychological test scores 2 to 6 months after stroke or TIA and appropriate normative data were used to calculate standardized cognitive domain scores. Domain-specific impairment was based on percentile cutoffs from normative groups, and associations between domain scores and risk factors were examined with 1-stage IPD meta-analysis. RESULTS: In a combined sample of 3,146 participants admitted to hospital for stroke (97%) or TIA (3%), 44% were impaired in global cognition and 30% to 35% were impaired in individual domains 2 to 6 months after the index event. Diabetes mellitus and a history of stroke were strongly associated with poorer cognitive function after covariate adjustments; hypertension, smoking, and atrial fibrillation had weaker domain-specific associations. While there were no significant differences in domain impairment among ethnoracial groups, some interethnic differences were found in the effects of risk factors on cognition. CONCLUSIONS: This study confirms the high prevalence of PSCI in diverse populations, highlights common risk factors, in particular diabetes mellitus, and points to ethnoracial differences that warrant attention in the development of prevention strategies.

Original languageEnglish
Pages (from-to)e2257-e2271
JournalNeurology
Volume93
Issue number24
DOIs
StatePublished - 10 Dec 2019

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Cognition
Stroke
Diabetes Mellitus
Social Adjustment
Neuropsychological Tests
Atrial Fibrillation
Meta-Analysis
Smoking
Hypertension
Cognitive Dysfunction
Population

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Stroke and Cognition (STROKOG) Collaboration. / Profile of and risk factors for poststroke cognitive impairment in diverse ethnoregional groups. In: Neurology. 2019 ; Vol. 93, No. 24. pp. e2257-e2271.
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title = "Profile of and risk factors for poststroke cognitive impairment in diverse ethnoregional groups",
abstract = "OBJECTIVE: To address the variability in prevalence estimates and inconsistencies in potential risk factors for poststroke cognitive impairment (PSCI) using a standardized approach and individual participant data (IPD) from international cohorts in the Stroke and Cognition Consortium (STROKOG) consortium. METHODS: We harmonized data from 13 studies based in 8 countries. Neuropsychological test scores 2 to 6 months after stroke or TIA and appropriate normative data were used to calculate standardized cognitive domain scores. Domain-specific impairment was based on percentile cutoffs from normative groups, and associations between domain scores and risk factors were examined with 1-stage IPD meta-analysis. RESULTS: In a combined sample of 3,146 participants admitted to hospital for stroke (97{\%}) or TIA (3{\%}), 44{\%} were impaired in global cognition and 30{\%} to 35{\%} were impaired in individual domains 2 to 6 months after the index event. Diabetes mellitus and a history of stroke were strongly associated with poorer cognitive function after covariate adjustments; hypertension, smoking, and atrial fibrillation had weaker domain-specific associations. While there were no significant differences in domain impairment among ethnoracial groups, some interethnic differences were found in the effects of risk factors on cognition. CONCLUSIONS: This study confirms the high prevalence of PSCI in diverse populations, highlights common risk factors, in particular diabetes mellitus, and points to ethnoracial differences that warrant attention in the development of prevention strategies.",
author = "{Stroke and Cognition (STROKOG) Collaboration} and Lo, {Jessica W.} and Crawford, {John D.} and Desmond, {David W.} and Olivier Godefroy and Hanna Jokinen and Simin Mahinrad and Bae, {Hee Joon} and Lim, {Jae Sung} and Sebastian K{\"o}hler and Elles Douven and Julie Staals and Christopher Chen and Xin Xu and Chong, {Eddie J.} and Akinyemi, {Rufus O.} and Kalaria, {Rajesh N.} and Adesola Ogunniyi and M{\'e}lanie Barbay and Martine Roussel and Lee, {Byung Chul} and Srikanth, {Velandai K.} and Christopher Moran and Nagaendran Kandiah and Chander, {Russell J.} and Behnam Sabayan and Jukema, {J. Wouter} and Susanna Melkas and Timo Erkinjuntti and Henry Brodaty and R{\'e}gis Bordet and St{\'e}phanie Bombois and Hilde H{\'e}non and Lipnicki, {Darren M.} and Kochan, {Nicole A.} and Sachdev, {Perminder S.}",
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Profile of and risk factors for poststroke cognitive impairment in diverse ethnoregional groups. / Stroke and Cognition (STROKOG) Collaboration.

In: Neurology, Vol. 93, No. 24, 10.12.2019, p. e2257-e2271.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Profile of and risk factors for poststroke cognitive impairment in diverse ethnoregional groups

AU - Stroke and Cognition (STROKOG) Collaboration

AU - Lo, Jessica W.

AU - Crawford, John D.

AU - Desmond, David W.

AU - Godefroy, Olivier

AU - Jokinen, Hanna

AU - Mahinrad, Simin

AU - Bae, Hee Joon

AU - Lim, Jae Sung

AU - Köhler, Sebastian

AU - Douven, Elles

AU - Staals, Julie

AU - Chen, Christopher

AU - Xu, Xin

AU - Chong, Eddie J.

AU - Akinyemi, Rufus O.

AU - Kalaria, Rajesh N.

AU - Ogunniyi, Adesola

AU - Barbay, Mélanie

AU - Roussel, Martine

AU - Lee, Byung Chul

AU - Srikanth, Velandai K.

AU - Moran, Christopher

AU - Kandiah, Nagaendran

AU - Chander, Russell J.

AU - Sabayan, Behnam

AU - Jukema, J. Wouter

AU - Melkas, Susanna

AU - Erkinjuntti, Timo

AU - Brodaty, Henry

AU - Bordet, Régis

AU - Bombois, Stéphanie

AU - Hénon, Hilde

AU - Lipnicki, Darren M.

AU - Kochan, Nicole A.

AU - Sachdev, Perminder S.

PY - 2019/12/10

Y1 - 2019/12/10

N2 - OBJECTIVE: To address the variability in prevalence estimates and inconsistencies in potential risk factors for poststroke cognitive impairment (PSCI) using a standardized approach and individual participant data (IPD) from international cohorts in the Stroke and Cognition Consortium (STROKOG) consortium. METHODS: We harmonized data from 13 studies based in 8 countries. Neuropsychological test scores 2 to 6 months after stroke or TIA and appropriate normative data were used to calculate standardized cognitive domain scores. Domain-specific impairment was based on percentile cutoffs from normative groups, and associations between domain scores and risk factors were examined with 1-stage IPD meta-analysis. RESULTS: In a combined sample of 3,146 participants admitted to hospital for stroke (97%) or TIA (3%), 44% were impaired in global cognition and 30% to 35% were impaired in individual domains 2 to 6 months after the index event. Diabetes mellitus and a history of stroke were strongly associated with poorer cognitive function after covariate adjustments; hypertension, smoking, and atrial fibrillation had weaker domain-specific associations. While there were no significant differences in domain impairment among ethnoracial groups, some interethnic differences were found in the effects of risk factors on cognition. CONCLUSIONS: This study confirms the high prevalence of PSCI in diverse populations, highlights common risk factors, in particular diabetes mellitus, and points to ethnoracial differences that warrant attention in the development of prevention strategies.

AB - OBJECTIVE: To address the variability in prevalence estimates and inconsistencies in potential risk factors for poststroke cognitive impairment (PSCI) using a standardized approach and individual participant data (IPD) from international cohorts in the Stroke and Cognition Consortium (STROKOG) consortium. METHODS: We harmonized data from 13 studies based in 8 countries. Neuropsychological test scores 2 to 6 months after stroke or TIA and appropriate normative data were used to calculate standardized cognitive domain scores. Domain-specific impairment was based on percentile cutoffs from normative groups, and associations between domain scores and risk factors were examined with 1-stage IPD meta-analysis. RESULTS: In a combined sample of 3,146 participants admitted to hospital for stroke (97%) or TIA (3%), 44% were impaired in global cognition and 30% to 35% were impaired in individual domains 2 to 6 months after the index event. Diabetes mellitus and a history of stroke were strongly associated with poorer cognitive function after covariate adjustments; hypertension, smoking, and atrial fibrillation had weaker domain-specific associations. While there were no significant differences in domain impairment among ethnoracial groups, some interethnic differences were found in the effects of risk factors on cognition. CONCLUSIONS: This study confirms the high prevalence of PSCI in diverse populations, highlights common risk factors, in particular diabetes mellitus, and points to ethnoracial differences that warrant attention in the development of prevention strategies.

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JO - Neurology

JF - Neurology

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