Factors influencing mini-mental state (MMSE) score in stroke patients

Abstract

Aim: To evaluate the usefulness of MMSE score in vascular dementia and the influence of different factors on the MMSE score.

Subject and methods: We studied 78 stroke patients followed up at the neurology unit, Specialistic Polyclinic 2, Tirana. A neurological visit is done and the MMSE score is calculated for each of them. We noted the stroke form (ischemic, hemorrhagic), patient's age, education, time from stroke onset, accompanying neurological disorders (parkinsonism, epilepsy), risk factors (arterial hypertension, cardiac diseases, diabetes mellitus, smoking, carotid stenosis). The imaging (CT and/or MRI) of the brain is requested. Independent Samples Test, t-test for Equality of Means, 2 - tailed, is applied for the statistical evaluation.

Results: The mean age of the patients in the study is 70.31 years old. There are 37 females (47.43%) and 41 males (52.56%). 12 (15.38%) patients had hemorrhagic and 66 (84.61%) ischemic stroke. The mean time from stroke onset is 4.55 years. 15 (19.2%) patients have parkinsonism, 1 other extra pyramidal disorder, 3 (3.8%) secondary generalized epilepsy. The mean MMSE score for all patients is 23.48. The multi ischemic cerebral lesions were present in the imaging of 12 (15.38%) patients. The generalized cortical atrophy is found in 25 (32%) patients and the temporal atrophy in 14 (17.94%) patients. We analyzed the data of 37 patients [16 (43.24%) females and 21 (56.75%) males], with MMSE score < or = 23. The mean age is 75.39 years old. 6 (16.21%) patients are diagnosed with hemorrhagic stroke. 3 (8.1%) patients have secondary generalized epilepsy, 9 (24.32%) are suffering of parkinsonism and the mean time from stroke onset is 4.31 years. The imaging study revealed multi ischemic cerebral lesions in 9 (24.3%) patients. We found accompanying temporal atrophy in 10 (27%) patients, frontal atrophy in 2 (5.4%) patients, and generalized cortical atrophy in 17 (45.9%) patients.

Conclusion: Dementia after stroke is frequent. The MMSE is still a useful scale to evaluate the VaD and is related to age, gender, education, stroke age, cardiovascular risk factors, stroke type and localization, other neurological disorders as epilepsy and parkinsonism.