Profile of and risk factors for poststroke cognitive impairment in diverse ethno-regional groups

Jessica W Lo; John D Crawford; David W Desmond; Olivier Godefroy; Hanna  Jokinen; Simin Mahinrad; Hee-Jon Bae; Jae-Sung Lim; Sebastian Köhler; Elles Douven; Julie Staals; Christopher Chen; Xin Xu; Eddie J Chong; Rufus O Akinyemi; Rajesh N Kalaria; Adesola Ogunniyi; Mélanie Barbay; Martine Roussel; Byung-Chul Lee; Velandai K Srikanth; Christopher Moran; Nagaendran Kandiah; Russell J Chander; Behnam Sabayan; J Wouter Jukema; Susanna Melkas; Timo J Erkinjuntti; Henry Brodaty; Régis Bordet; Stéphanie Bombois; Hilde Hénon; Darren M Lipnicki; Nicole A Kochan; Perminder S Sachdev

doi:10.1212/WNL.0000000000008612

Profile of and risk factors for poststroke cognitive impairment in diverse ethno-regional groups

Jessica W Lo, John D Crawford, David W Desmond, Olivier Godefroy, Hanna Jokinen, Simin Mahinrad, Hee-Jon Bae, Jae-Sung Lim, Sebastian Köhler, Elles Douven, Julie Staals, Christopher Chen, Xin Xu, Eddie J Chong, Rufus O Akinyemi, Rajesh N Kalaria, Adesola Ogunniyi, Mélanie Barbay, Martine Roussel, Byung-Chul LeeVelandai K Srikanth, Christopher Moran, Nagaendran Kandiah, Russell J Chander, Behnam Sabayan, J Wouter Jukema, Susanna Melkas, Timo J Erkinjuntti, Henry Brodaty, Régis Bordet, Stéphanie Bombois, Hilde Hénon, Darren M Lipnicki, Nicole A Kochan, Perminder S Sachdev

Research output: Contribution to journal › Article › Scientific › peer-review

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 language	English
Journal	Neurology
Volume	93
Issue number	24
Pages (from-to)	e2257-e2271
Number of pages	16
ISSN	0028-3878
DOIs	https://doi.org/10.1212/WNL.0000000000008612
Publication status	Published - Dec 2019
MoE publication type	A1 Journal article-refereed

Fields of Science

3124 Neurology and psychiatry
515 Psychology

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10.1212/WNL.0000000000008612Licence: CC BY-NC-ND

e2257.fullFinal published version, 2.46 MBLicence: CC BY-NC-ND

1 Active

STROKOG: Stroke and Cognition Consortium
STROKOG Consortium, Jokinen, H., Melkas, S., Erkinjuntti, T. J. & Laakso, H.
01/05/2016 → 31/12/2023
Project: Research project

Cite this

Lo, J. W., Crawford, J. D., Desmond, D. W., Godefroy, O., Jokinen, H., Mahinrad, S., Bae, H-J., Lim, J-S., Köhler, S., Douven, E., Staals, J., Chen, C., Xu, X., Chong, E. J., Akinyemi, R. O., Kalaria, R. N., Ogunniyi, A., Barbay, M., Roussel, M., ... Sachdev, P. S. (2019). Profile of and risk factors for poststroke cognitive impairment in diverse ethno-regional groups. Neurology, 93(24), e2257-e2271. https://doi.org/10.1212/WNL.0000000000008612

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title = "Profile of and risk factors for poststroke cognitive impairment in diverse ethno-regional 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.",

keywords = "3124 Neurology and psychiatry, 515 Psychology",

author = "Lo, {Jessica W} and Crawford, {John D} and Desmond, {David W} and Olivier Godefroy and Hanna Jokinen and Simin Mahinrad and Hee-Jon Bae and Jae-Sung Lim 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 Byung-Chul Lee 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 Erkinjuntti, {Timo J} 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}",

year = "2019",

month = dec,

doi = "10.1212/WNL.0000000000008612",

language = "English",

volume = "93",

pages = "e2257--e2271",

journal = "Neurology",

issn = "0028-3878",

publisher = "Lippincott williams & wilkins",

number = "24",

}

Lo, JW, Crawford, JD, Desmond, DW, Godefroy, O, Jokinen, H, Mahinrad, S, Bae, H-J, Lim, J-S, Köhler, S, Douven, E, Staals, J, Chen, C, Xu, X, Chong, EJ, Akinyemi, RO, Kalaria, RN, Ogunniyi, A, Barbay, M, Roussel, M, Lee, B-C, Srikanth, VK, Moran, C, Kandiah, N, Chander, RJ, Sabayan, B, Jukema, JW, Melkas, S , Erkinjuntti, TJ, Brodaty, H, Bordet, R, Bombois, S, Hénon, H, Lipnicki, DM, Kochan, NA & Sachdev, PS 2019, 'Profile of and risk factors for poststroke cognitive impairment in diverse ethno-regional groups', Neurology, vol. 93, no. 24, pp. e2257-e2271. https://doi.org/10.1212/WNL.0000000000008612

TY - JOUR

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

AU - Lo, Jessica W

AU - Crawford, John D

AU - Desmond, David W

AU - Godefroy, Olivier

AU - Jokinen, Hanna

AU - Mahinrad, Simin

AU - Bae, Hee-Jon

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 J

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

Y1 - 2019/12

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.

KW - 3124 Neurology and psychiatry

KW - 515 Psychology

U2 - 10.1212/WNL.0000000000008612

DO - 10.1212/WNL.0000000000008612

M3 - Article

VL - 93

SP - e2257-e2271

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 24

ER -

Profile of and risk factors for poststroke cognitive impairment in diverse ethno-regional groups

Abstract

Fields of Science

Access to Document

Projects

STROKOG: Stroke and Cognition Consortium

Cite this