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. 2019 Jun;4(2):160-171.
doi: 10.1177/2396987318825484. Epub 2019 Jan 16.

Systematic review and meta-analysis of the prevalence of cognitive impairment no dementia in the first year post-stroke

Eithne Sexton  1 , Affraic McLoughlin  1 , David J Williams  2 , Niamh A Merriman  1 , Nora Donnelly  3 , Daniela Rohde  1 , Anne Hickey  1 , Maev-Ann Wren  3 , Kathleen Bennett  4
Affiliations

Systematic review and meta-analysis of the prevalence of cognitive impairment no dementia in the first year post-stroke

Eithne Sexton et al. Eur Stroke J. 2019 Jun.

Abstract

Introduction: Increasing attention is being paid to interventions for cognitive impairment (CI) post-stroke, including for CI that does not meet dementia criteria. The aim of this paper was to conduct a systematic review and meta-analysis of the prevalence of cognitive impairment no dementia (CIND) within one year post-stroke.

Patients and methods: Pubmed, EMBASE and PsychInfo were searched for papers published in English in 1995-2017. Included studies were population or hospital-based cohort studies for first-ever/recurrent stroke, assessing CIND using standardised criteria at 1-12 months post-stroke. Abstracts were screened, followed by full text review of potentially relevant articles. Data were extracted using a standard form, and study quality was appraised using the Crowe Critical Appraisal Tool. A pooled prevalence of CIND with 95% confidence intervals (CI) was estimated using random-effects meta-analysis. Heterogeneity was measured using the I2 statistic.

Results: A total of 7000 abstracts were screened, followed by 1028 full text articles. Twenty-three articles were included in the systematic review, and 21 in the meta-analysis. The pooled CIND prevalence was 38% [95% CI = 32-43%] (I2=92.5%, p < 0.01). Study quality emerged as one source of heterogeneity. The five studies with the highest quality scores had no heterogeneity (I2=0%, p = 0.99), with a similar pooled prevalence (39%, 95%CI = 35-42%). Other sources of heterogeneity were stroke type, inclusion of pre-stroke CI, and age at assessment time.Discussion and conclusion: Meta-analysis of available studies indicates that in the first year post-stroke, 4 in 10 patients display a level of cognitive impairment that does not meet the criteria for dementia.

Keywords: Stroke; cognition; dementia; systematic reviews.

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Figures

Figure 1.
Figure 1.
Flow chart of included studies.
Figure 2.
Figure 2.
Pooled prevalence of CIND in the first year post-stroke.
Figure 3.
Figure 3.
Pooled prevalence of CIND in the first year post-stroke, stratified by quality quartile.
Figure 4.
Figure 4.
Pooled prevalence of CIND in first year post-stroke, in high and medium-high quality studies, stratified by stroke type. IS: Ischaemic stroke, TIA: Transient Ischaemic Attack; H: Haemorrhagic stroke.
Figure 5.
Figure 5.
Pooled prevalence of CIND in first year post-stroke, in high and medium-high quality studies, stratified by mean age of the study sample.
See this image and copyright information in PMC

References

    1. Cumming TB, Brodtmann A, Darby D, et al. The importance of cognition to quality of life after stroke. J Psychosom Res 2014; 77: 374–379. - PubMed
    1. Pendlebury ST, Rothwell PM. Prevalence, incidence, and factors associated with pre-stroke and post-stroke dementia: a systematic review and meta-analysis. Lancet Neurol 2009; 8: 1006–1018. - PubMed
    1. Harrison SL, Tang EYH, Keage HAD, et al. A systematic review of the definitions of vascular cognitive impairment, no dementia in cohort studies. Dement Geriatr Cogn Disord 2016; 42: 69–79. - PubMed
    1. Pendlebury ST, Mariz J, Bull L, et al. Impact of different operational definitions on mild cognitive impairment rate and MMSE and MoCA performance in transient ischaemic attack and stroke. Cerebrovasc Dis 2013; 36: 355–362. - PMC - PubMed
    1. Petersen R, Doody R, Kurz A, et al. Current concepts in mild cognitive impairment. Arch Neurol 2001; 58: 1985–1992. - PubMed

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