Cognitive impairment after sudden cardiac arrest

Abstract

Aim: To evaluate the incidence and severity of the impairment of selected cognitive functions in patients after sudden cardiac arrest (SCA) in comparison to patients after myocardial infarction without SCA and healthy subjects and to analyze the influence of sociodemographic and clinical parameters and the duration of cardiac arrest on the presence and severity of the described disorders.

Material and methods: The study group comprised 30 cardiac arrest survivors, the reference group comprised 31 survivors of myocardial infarction without cardiac arrest, and the control group comprised 30 healthy subjects. The Mini-Mental State Examination (MMSE), the Digit Span test from the Wechsler Adult Intelligence Scale, Lauretta Bender's Visual-Motor Gestalt Test, and the Benton Visual Retention Test (BVRT) were used to assess the presence of cognitive impairment. An original questionnaire developed by the author was used for overall mental state assessment.

Results: The Bender test demonstrated a significant difference in the presence and severity of visual-motor skills between the study group and the control group, while BVRT and MMSE revealed increased incidence of cognitive impairment in the study group. The Bender and BVRT (D/D)/SS (version D, method D, scaled score) scales indicated cognitive impairment in 53.3% of these patients, while the BVRT (C/A)/SS test indicated cognitive impairment in 40%. For the reference group, the values were 32.3% and 12.9%, respectively. No correlation was found between the severity of cognitive impairment and the duration of cardiac arrest.

Conclusions: Impairment of visual-motor skills, short-term visual memory, concentration, and visual-motor coordination occurs much more frequently and is more severe in individuals after SCA than in healthy individuals. Impairment of memory trace storage and recall after delay occurs more frequently in patients after SCA than in patients after myocardial infarction without cardiac arrest and in healthy individuals. SCA duration did not have any influence on the severity of the described disorders.

Keywords: cardiac arrest; cognitive function; coronary heart disease.

Fig. 1

Bender test scores in each group (0 – no disorder, 1 – low severity, 2 – moderate severity, 3 – significant severity)

Fig. 2

Mean values and standard deviations on the BVRT (C/A)/NCR (number of correct reproductions) scale in each group

Fig. 3

Mean values and standard deviations on the BVRT (C/A)/NM (number of mistakes) scale in each group

Fig. 4

Values on the BVRT (C/A)/SS scale in each group (0 – no disorder, 1 – low severity, 2 – moderate severity, 3 – significant severity)

Fig. 5

Mean values and standard deviations on the BVRT (D/D)/ NCR (number of correct reproductions) scale in each group

Fig. 6

Mean values and standard deviations on the BVRT (D/D)/ NM (number of mistakes) scale in each group

Fig. 7

Values on the BVRT (D/D)/SS scale in each group (0 – no disorder, 1 – low severity, 2 – moderate severity, 3 – significant severity)

Fig. 8

Incidence of dementia in each group according to the MMSE