J of IMAB. 2012; 18(3):298-301
THE IMPACT OF COMORBIDITY ON COGNITIVE PARAMETERS AFTER ISCHEMIC STROKE
Mirena Valkova, Boyko Stamenov, Dora Peychinska
Department of Neurology and Neurosurgery, Medical University, Pleven, Bulgaria.

ABSTRACT:
Objective: The aim of our study is to examine the impact of comorbidity on cognitive parameters after the first ever ischemic stroke.
Material and methods: We examined 112 patients (aged 46 to 84 (66.67± 5.96), 69 males and 43 females) with first ever ischemic stroke. For cognitive assessment we used Mini Mental State Examination (MMSE), 10 word test (for short term memory and delayed recall), Isaack’s test for verbal fluency (VF), Geriatric depression scale (GDS), Hamilton depression scale (HDS), Blessed dementia information memory concentration test (revised, BDIMCT), Benton Visual Retention test (A,E; BVRT) – number of corrects and number of errors and Wiskonsin Card Sorting Test (number of errors, WCST). The patients were examined on two step model. At acute stage, after collecting medical history, somatic and neurological examinations, MMSE, 10 words test and HDS were applied. At subacute stroke stage (90±5 days after first stroke symptoms), all cognitive tests were used. „STATGRAPHICS Plus 5.0 (free version)” was used for statistical analysis.
Results: Chronic ischemic heart disease and chronic obstructive pulmonary disease are the most important additional risk factors for cognitive decline. Thyroid pathology, renal failure and anemia are independently associated with poststroke depression.
Conclusions: On the basis of these data we can conclude that vascular risk factors are independently associated with cognitive and emotional changes after stroke and their effects should be assessed and taken into account for subsequent treatment of stroke survivors.

Key words: comorbid diseases, postroke depression, poststroke cognitive impairment, vascular risk factors.

- Download FULL TEXT /PDF 538 KB/
Please cite this article as: Valkova M, Stamenov B, Peychinska D. THE IMPACT OF COMORBIDITY ON COGNITIVE PARAMETERS AFTER ISCHEMIC STROKE. J of IMAB. 2012; 18(3):298-301. doi: 10.5272/jimab.2012183.298.

REFERENCES:
1. Titianova E, Velcheva I, Karakaneva S, Dimitrov DN, Hristova K, Damianov P et al. Carotid Pathology and risk factors for Cerebrovascular Disease – correlative clinical, neurosonographic and echocardiographic studies. Neurosonology and cerebral hemodynamics. 2007, 3(2): 77-84
2. Velcheva I. Prophylaxis of ischemic strokes. Medinfo. 2011, 6: 10-16
3. Iijima K, Akishita M, Ouchi Y. Coronary artery calcification and cerebral small vessel disease. Association of systemic atherosclerosis. Circ J. 2011; 75(2):272-3. [PubMed] [CrossRef]
4. Okonkwo OC, Cohen RA, Gunstad J, Tremont G, Alosco ML, Poppas A. Longitudinal trajectories of cognitive decline among older adults with cardiovascular disease. Cerebrovasc Dis. 2010; 30(4):362-73. [PubMed] [CrossRef]
5. Reitz C, Luchsinger JA, Mayeux R. Vascular disease and cognitive impairment. Expert Rev Neurother. 2008 Aug;8(8):1171-4. [PubMed] [CrossRef]
6. Llewellyn DJ, Lang IA, Xie J, Huppert FA, Melzer D, Langa KM. Framingham Stroke Risk Profile and poor cognitive function: a population-based study. BMC Neurol. 2008 Apr 22;8:12. [PubMed] [CrossRef]
7. Rowan E, Morris CM, Stephens S, Ballard C, Dickinson H, Rao H, et al. Impact of hypertension and apolipoprotein E4 on poststroke cognition in subjects >75 years of age. Stroke. 2005 Sep;36(9):1864-8. [PubMed] [CrossRef]
8. Sachdev PS, Brodaty H, Looi JC. Vascular dementia: diagnosis, management and  possible  prevention. Med J Aust. 1999 Jan 18;170(2):81-5. [Pubmed]
9. Conradi AO. Antihypertensive therapy in prophylaxis and correction of cognitive impairments. Consilium Midicum, 2005, 1(3).
10. Jennings JR, Muldoon MF, Price J, Christie IC, Meltzer CC. Cerebrovascular support for cognitive processing in hypertensive patients is altered by blood pressure treatment. Hypertension. 2008 Jul;52(1):65-71. [PubNed] [CrossRef]
11. De Carolis A, Giubilei F, Caselli G, Casolla B, Cavallari M, Vanacore N, et al. Chronic obstructive pulmonary disease is associated with altered neuropsychological performance in young adults. Dement Geriatr Cogn Dis Extra. 2011 Jan;1(1):402-8. [PubMed] [CrossRef]
12. Lass P, Slawek J, Derejko M, Rubello D. Neurological and psychiatric disorders in thyroid dysfunctions. The role of nuclear medicine: SPECT and PET imaging. Minerva Endocrinol. 2008 Jun;33(2):75-84. [PubMed]
13. Titianova E, Velcheva I, Stamenov B. Treatment of Acute Ischemic Stroke with Thrombolysis in Bulgaria. Neurosonology and cerebral hemodynamics. 2010; 6 (1):15-19.