Vascular Cognitive Impairment in Ischemic Stroke Patients


ABSTRACT:BACKGROUND: Stroke is associated with considerable physical and psychological impairment. Cognitive impairment is common sequel of stroke and small vessel ischemic disease. Potentially modifiable risk factors for vascular cognitive impairment (VCI) include hypertension, DM, hyperlipidemia and others. Because of the close association of these factors with stroke, prevention of VCI is largely tied to control of stroke risk factors. OBJECTIVE: The main aims of the study were to ascertain the significant determinants of cognitive impairment in stroke patients and the associated risk factors.PATIENTS AND METHODS: This is a case series descriptive study that enrolled 100 patients whose ages were 50 years and above with stroke attending at Al-Yarmouk Teaching Hospital in Baghdad-Iraq during the period between the 1st of January 2007 to the 31st of January 2008. All of the patients were asked about demographic and atherogenic risk factors and subjected to cognitive assessment by MMSE and executive function also the patients subjected to thorough clinical assessment, laboratory investigations and radiological studies.RESULTS: This study revealed that distribution of VCI in stroke patients was 27%, the patients with vascular CIND represent 19% and those with VaD represent 8%. The mean age of the patients was 65. The most common risk factors were hypertension 25%, hypercholesterolemia 20%, smoking 17%, acute myocardial infarction 10%, diabetes 10% and atrial fibrillation 5%. We observed that increasing age, low level of education and acute myocardial infarction were significant determinants of cognitive impairment in stroke patients.CONCLUSION: Considerable proportion of stroke patients presented with cognitive impairment which is determined by modifiable risk factors like atherogenic and demographic risk factors.