Table 2.
Studies investigating the associations between stroke, cognitive impairments, and neuropsychological assessments within 3 months of stroke onset
| Author (year) | Stroke characteristics (patients’ demography) | Risk factors | Cognitive impairment associated with PSD | Neuropsychological tests and cognitive decline evaluation |
|---|---|---|---|---|
| Tham et al32 (2002) | N=252 TIA (N=140 intact; age: 56.7 years; N=102 CIND, age: 65.1 years; N=10, D, age: 60.4 years) M/F =66/34 | Hypertension, previous stroke, hyperlipidemia, diabetes, ischemic heart disease | Attention, language, verbal memory, visual memory, visuoconstruction, visuomotor speed | Tests: MMSE; WMS-R; CDT; WAIS; digital cancellation task; digital symbol modalities test; maze task; picture recall; mBNT; auditory detection test. Evaluation: subject classified by DSM-IV; MMSE score: 27.4 for intact, 23.5 for CI, 17.0 for D |
| Auchus et al37 (2002) | N=125 VaD; N=12 SSID, age: 69 years; M/F =58/41 | Hypertension, myocardial infarction, diabetes mellitus | Attention, language (naming and verbal fluency), verbal memory (recall and recognition), visual memory (recall and recognition), and visuoconstruction | Tests: attention, language (naming and verbal fluency); verbal memory (recall and recognition); visual memory (recall and recognition); and visuoconstruction; together with the MMSE and screening for depression. Evaluation: VaD identified by NINDS–AIREN. Subject classified by DSM-III-R. MMSE score: 17.5 (range: 9–24) |
| Garrett et al41 (2004) | N=26 VaD, age: 77.1 years, M/F =66/34; N=18, VCIND, age: 78.4 years, M/F =56/29. Individual risk factors of CVD: age: 67.4 years, M/F =62/63; N=25, controls, age: 76.5 years, M/F =44/43 |
CVD | Visual memory, verbal fluency, verbal list-learning and memory abilities | Tests: TMT part A and B; CVLT; BNT; COWAT; MMSE; and CDR. Evaluation: subject classified by DSM-III; VaD identified by NINDS–AIREN. MMSE score: 28.2 for early control, 28.9 for individual at risk for CVD, 26.3 for VCIND, 26 for VaD |
| Mok42 (2004) | N=75 patients, age: 71 years, M/F =41.5/58.5; N=42 control, age: 69.6 years, M/F =47/48 | Diabetes, previous stroke, hyperlipidemia, heart disease, smoking, alcohol use | Memory, thinking (decision making or answering questions), orientation (in time, place, or person), aphasia, and speech comprehension | Tests: CDR; MMSE; MDRS; IQCODE. Evaluation: daily living activity assessed by BI, IADL. MMSE score: 27.7 for control; 24.8 for patients |
| Graham et al40 (2004) | N=19 subcortical VaD, age: 71.2 years, M/F =73.6/26; N=19 AD, age: 68.9 years, M/F =47.3/52.6; N=19 controls, age: 68.1 years, M/F =47.3/52.6 | CVD | Episodic and semantic memory, executive/attentional functioning, and visuospatial and perceptual skills | Tests: MMSE; ACE-R; CDR; CBI. Evaluation: VaD identified by NINDS–AIREN. MMSE score: 25.3 for VaD patients, 24.2 for AD patients |
| Sachdev et al39 (2004) | N=123 patients, age: 72 years, M/F =39.7/40.7; N=78 control, age: 70.6 years, M/F =43.9/44.9 | Hypertension, diabetes, AF, CAD hyperlipidemia, smoking, alcohol use | Attention, global memory, verbal memory, visual memory, executive, abstraction, working memory, language, visuoconstruction | Tests: MMSE; WMS-R; BNT, WAIS-R; TMT part A and B; HAM-D; IQCODE. Evaluation: daily living activity assessed by ADL. MMSE score: 28.4 for control, 27.6 for patients |
| Firbank et al6 (2007) | N=79 patients (N=65 ND, age: 80.1 years, M/F =50/50; N=14 D, age: 80 years, M/F =64/35) | CVD | Medial temporal lobe atrophy associated with cognitive decline and brain atrophy, increasing the suggested role for AD | Tests: CAMCOG-R; MMSE; Sheffield language screening test. Evaluation: subject classified by DSM-IV. Daily living activity assessed by Bristol activity; stroke assessed by OCSP. MMSE score: 26 for ND, 25.1 for D |
| Mok et al33 (2008) | N=61 patients, age: 68.7 years, M/F =53/47; N=35 control, age: 68.9 years, M/F =37.1/62.9 | Hypertension, diabetes mellitus, hyperlipidemia, heart disease, smoking, alcohol use | Verbal learning and memory, orientation, language, praxis and visuospatial functions, verbal fluency, and verbal, motor, and graphomotor programming | Test: MMSE. Evaluation: subject classified by CDR; stroke assessed by NIHSS. Daily living activity assessed by BI, MDRS, Lawton’s IADL index, AD assessed by ADAS-cog. MMSE score: 27.6 for control, 25.7 for patients |
| Stebbins et al38 (2008) | N=91 patients (N=51 NCI, age: 63.1 years, M/F =52/47; N=40 cognitive impairment, age: 67.4 years, M/F =47/52) | CVD | Orientation, attention, working memory, language, visuospatial, psychomotor, memory | Tests: IQCODE; MMSE; digital forward; WMS-R; digital backward; BNT; BDAE; animal naming; figure recognition test; Raven’s matrices; grooved pegs domain; symbol digital oral score; CLTR. Evaluation: subject classified by DSM-IV. MMSE score: 28.7 for NCI, 25.8 for CI |
| Jaillard et al36 (2009) | N=177 patients, age: 50.6, M/F =62.3/36.7; N=81 control, age: 51.9 years, M/F =58/42 | Hypertension, diabetes mellitus, admission glycemia, low-density lipoprotein cholesterol, smoking, alcohol use, homocysteine | Short-term memory, episodic memory, executive function, working memory | Tests: MMSE; WAIS. Evaluation: stroke assessed by NIHSS. MMSE score: 28.5 for patients, 29.15 controls |
| Khedr et al34 (2009) | N=81 patients (N=17 D, age: 65.5±9.2 years, M/F =64/35; N=64 ND, age: 56.9±5.3 years, M/F =67/32 | Hypertension, homocysteine level, smoking, CVD | Orientation, repetition of words, attention, calculation, recall of words, language, visual construction | Tests: IQCODE; MMSE; WMS-R; CASI. Evaluation: subject classified by DSM-IV. MMSE score at baseline: 25.58 for patients; 25.72 for control. MMSE score after 3 months: 22.77 for patients, 26.04 for control |
| Kandiah et al35 (2011) | N=97 NCI, age: 53 years, M/F =71/29; N=48 CI, age: 61 years, M/F =40/60 | Hypertension, diabetes, hypercholesterolemia | Executive function, memory, visuospatial | Tests: MMSE; MoCA; FAB; IQCODE. Evaluation: subject classified by DSM-IV-TR, CDR. Stroke assessed by Rankin score. MMSE score: 29.1 for NCI, 26.4 for CI |
Notes: M/F values were represented as percentages. Age is given as the average age in years.
Abbreviations: PSD, poststroke dementia; N, number of patients; TIA, transient ischemic attack; CIND, cognitive impairment no dementia; D, dementia; M, male; F, female; MMSE, Mini-Mental State Examination; WMS-R, Wechsler Memory Scale-Revised; CDT, Clock Diagnostic Test; WAIS, Wechsler Adult Intelligence Scale; mBNT, modified Boston Naming Test; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders Revised, fourth edition; CI, cognitively impaired; VaD, vascular dementia; SSID, strategic single infarct dementia; NINDS–AIREN, National Institute of Neurologic Disorders and Stroke and the Association International pour la Recherche et l’Enseignement en Neurosciences; DSM-III-R, Diagnostic and Statistical Manual of Mental Disorders, Revised, third edition; VCIND, vascular cognitive impairment no dementia; CVD, cerebrovascular disease; TMT, Trail Making Test; CVLT, California Verbal Learning Test; BNT, Boston Naming Test; COWAT, Control Oral World Association Test; CDR, Clinical Dementia Rating Scale; DSM-III, Diagnostic and Statistical Manual of Mental Disorders, third edition; MDRS, Mattis Dementia Rating Scale; IQCODE, Informant Questionnaire on Cognitive Decline of Elderly; NIHSS, National Institutes of Health Stroke Scale; BI, Barthel Index; IADL, instrumental activity of daily living; ACE-R, Addenbrooke’s Cognitive Examination; CBI, Cambridge Behavioral Inventory; AD, Alzheimer’s disease; AF, atrial fibrillation; CAD, coronary artery disease; WAIS-R, Wechsler Adult Intelligence Scale-Revised; Ham-D, Hamilton Depression Rating Scale; ADL, activity of daily living; ND, no dementia; CAMCOG-R, Cambridge Assessment of Mental Disorders in Elderly, Revised; OCSP, Oxfordshire Community Stroke Project; ADAS-cog, Alzheimer’s Disease Assessment Scale–Cognitive Subset; NCI, noncognitive impairment; BDAE, Boston Diagnostic Aphasia Examination; CLTR, Control Learning and Enhancing Recall; CASI, Cognitive Abilities Screening Instrument; MoCA, Montreal Cognitive Assessment; FAB, Frontal Assessment Battery; DSM-IV-TR, Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision.