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Prevalence of post-stroke cognitive impairment in china: a community-based, cross-sectional study.

ABSTRACT: International hospital-based studies have indicated a high risk of cognitive impairment after stroke, evidence from community-based studies in China is scarce. To determine the prevalence of post-stroke cognitive impairment (PSCI) and its subtypes in stroke survivors residing in selected rural and urban Chinese communities, we conducted a community-based, cross-sectional study in 599 patients accounting for 48% of all stroke survivors registered in the 4 communities, who had suffered confirmed strokes and had undergone cognitive assessments via the Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), and Hachinski Ischemia Scale (HIS). Detection of PSCI was based on scores in these neuropsychological scales. Factors potentially impacting on occurrence of PSCI were explored by comparing demographic characteristics, stroke features, and cardiovascular risk factors between patients with and without PSCI. The overall prevalence of PSCI was 80.97% (95%CI: 77.82%-84.11%), while that of non-dementia PSCI (PSCI-ND) and post-stroke vascular dementia (PSD) was 48.91% (95%CI: 44.91%-52.92%) and 32.05% (95%CI: 28.32%-35.79%), respectively. Prior stroke and complications during the acute phase were independent risk factors for PSCI. The risk of recurrent stroke survivors having PSCI was 2.7 times higher than for first-episode survivors, and it was 3 times higher for those with complications during the acute phase than for those without. The higher prevalence of PSCI in this study compared with previous Chinese studies was possibly due to the combined effects of including rural stroke survivors, a longer period from stroke onset, and different assessment methods. There is an urgent need to recognize and prevent PSCI in stroke patients, especially those with recurrent stroke and complications during the acute phase.

SUBMITTER: Qu Y

PROVIDER: S-EPMC4395303 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Prevalence of post-stroke cognitive impairment in china: a community-based, cross-sectional study.

Qu Yanji Y Zhuo Lin L Li Na N Hu Yiqing Y Chen Weihua W Zhou Yun Y Wang Jinwei J Tao Qingmei Q Hu Jing J Nie Xiaolu X Zhan Siyan S

PloS one 20150413 4

International hospital-based studies have indicated a high risk of cognitive impairment after stroke, evidence from community-based studies in China is scarce. To determine the prevalence of post-stroke cognitive impairment (PSCI) and its subtypes in stroke survivors residing in selected rural and urban Chinese communities, we conducted a community-based, cross-sectional study in 599 patients accounting for 48% of all stroke survivors registered in the 4 communities, who had suffered confirmed s ...[more]

PMID: 25874998

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Project description:BackgroundMotor and cognitive impairments are frequently observed following stroke, but are often managed as distinct entities, and there is little evidence regarding how they are related. The aim of this study was to describe the prevalence of concurrent motor and cognitive impairments 3 months after stroke and to examine how motor performance was associated with memory, executive function and global cognition.MethodsThe Norwegian Cognitive Impairment After Stroke (Nor-COAST) study is a prospective multicentre cohort study including patients hospitalized with acute stroke between May 2015 and March 2017. The National Institutes of Health Stroke Scale (NIHSS) was used to measure stroke severity at admission. Level of disability was assessed by the Modified Rankin Scale (mRS). Motor and cognitive functions were assessed 3 months post-stroke using the Montreal Cognitive Assessment (MoCA), Trail Making Test Part B (TMT-B), 10-Word List Recall (10WLR), Short Physical Performance Battery (SPPB), dual-task cost (DTC) and grip strength (Jamar®). Cut-offs were set according to current recommendations. Associations were examined using linear regression with cognitive tests as dependent variables and motor domains as covariates, adjusted for age, sex, education and stroke severity.ResultsOf 567 participants included, 242 (43%) were women, mean (SD) age was 72.2 (11.7) years, 416 (75%) had an NIHSS score???4 and 475 (84%) had an mRS score of ?2. Prevalence of concurrent motor and cognitive impairment ranged from 9.5% for DTC and 10WLR to 22.9% for grip strength and TMT-B. SPPB was associated with MoCA (regression coefficient B?=?0.465, 95%CI [0.352, 0.578]), TMT-B (B?=?-9.494, 95%CI [-?11.726, -?7.925]) and 10WLR (B?=?0.132, 95%CI [0.054, 0.211]). Grip strength was associated with MoCA (B?=?0.075, 95%CI [0.039, 0.112]), TMT-B (B?=?-1.972, 95%CI [-?2.672, -?1.272]) and 10WLR (B?=?0.041, 95%CI [0.016, 0.066]). Higher DTC was associated with more time needed to complete TMT-B (B?=?0.475, 95%CI [0.075, 0.875]) but not with MoCA or 10WLR.ConclusionThree months after suffering mainly minor strokes, 30-40% of participants had motor or cognitive impairments, while 20% had concurrent impairments. Motor performance was associated with memory, executive function and global cognition. The identification of concurrent impairments could be relevant for preventing functional decline.Trial registrationClinicalTrials.gov Identifier: NCT02650531 .

Project description:OBJECTIVES:Epidemiological studies aimed at stroke and its risk factors can help identify persons at higher risk and therefore promote stroke prevention strategies. We aimed to explore the current prevalence of stroke and its associated risk factors in northeast China. DESIGN:Population based cross sectional study. SETTING:Data were collected using a structured precoded questionnaire designed by the Stroke Screening and Prevention Programme of the National Health and Family Planning Commission of China, between January and March 2016. PARTICIPANTS:4100 permanent residents, aged 40 years or older, who had lived in Dehui City of Jilin Province for more than 6 months volunteered to participate in the survey, with a response rate of 92.2%. For the purpose of the present analysis, 48 subjects were excluded due to missing values, giving a total of 4052 people included in this analysis. MAIN OUTCOME MEASURE:The questionnaire included demographic characteristics, stroke related behavioural factors, personal and family medical history of stroke, physical examination and laboratory testing. RESULTS:The overall prevalence of stroke in Jilin Province was 7.2% (95% CI 6.3% to 8.2%). Of all stroke cases, 91.7% (95% CI 87.4% to 94.6%) were ischaemic stroke and 8.3% (95% CI 5.4% to 12.6%) were haemorrhagic stroke. The prevalence rates of dyslipidaemia, smoking and hypertension were ranked as the top three cerebrovascular risk factors and were 62.1%, 61.8% and 57.3%, respectively. We found that hypertension, dyslipidaemia and lack of exercise were associated with ischaemic stroke. However, only hypertension (OR=4.064, 95%?CI 1.358 to 12.160) was significantly associated with haemorrhagic stroke. CONCLUSIONS:The prevalence of stroke, especially ischaemic stroke, and associated cerebrovascular risk factors among adults aged 40 years or older in northeast China were high. A higher regional prevalence of hypertension, dyslipidaemia and lack of exercise may be responsible.

Project description:ObjectivesTo derive normative carotid artery stiffness data in rural adult Chinese population-based study of ultrasound measurements of carotid elasticity by using quality arterial stiffness (QAS), and to assess the changes of relevant parameters in Chinese adults 40 years of age and older.DesignA China stroke cohort study (total number: 1586) in the northern countryside were carried out between June 2013 and April 2016, designed to investigate the risk factors of cardiovascular and age-related diseases.SettingThe present study was a cross-sectional analysis of an ongoing community-based Shunyi cohort study in China.ParticipantsA total of 583 participants (227 men and 356 women; aged 40-80 years) with ultrasound carotid QAS examination were retrieved from the study to analyse.Primary and secondary outcome measuresArterial stiffness parameters included diastolic diameter (Dd), pulse wave velocity (PWV), stiffness indices α and β were calculated by QAS. Other clinical indicators included physical measurements, medical histories and blood biochemical test.ResultsIn the entire study sample, mean Dd was 7.93±0.88 mm, mean PWV was 9.4±2.4 m/s, mean α was 7.65±5.13 and mean β was 15.53±10.29. PWV was significant higher in participants with hypertension (9.9 m/s vs 9.2 m/s in those without, p=0.002), and with diabetes (10.3 m/s vs 9.2 m/s in those without, p=0.003). PWV were significantly higher in participants with HbA1c at 5.8%-6.4% versus <5.8%, but no difference was found between subjects with glycohaemoglobin (HbA1c) at 5.8%-6.4% versus >6.4% (p=0.005, p=0.955, respectively). Age increase by every 10 years was associated with Dd increased by 0.27 mm, PWV increased by 1.2 m/s, α increased by 1.34 and β increased by 2.71. Systolic blood pressure (SBP) increase by every 10 mm Hg was associated with Dd increased by 0.15 mm, PWV increased by 0.35 m/s, α increased by 0.13 and β increased by 0.15.ConclusionAmong the participants older than 40 years, stiffness of the carotid artery had differences between hypertension and non-hypertension adults, as well as between diabetes and non-diabetes adults. Stiffness of the carotid artery also have differences between adults with HbA1c at 5.8%-6.4% versus <5.8%. Stiffness of the carotid artery increases with increasing age and increasing SBP at a range from 40 and up.

Project description:ObjectiveHypertension (HTN) is an important public health issue worldwide, associated with the rapid economic development and urbanisation over the last decades. This is especially the case in Shenzhen, which has benefited greatly from the reform and opening-up policies. However, there is limited information on the epidemiology of HTN in this region. This study was designed to investigate the prevalence, awareness, treatment and control of HTN and the associated factors among adult residents in Shenzhen, China.DesignPopulation-based, cross-sectional study.ParticipantsThrough the multistage stratified random sampling method, a representative sample of 10 043 urban population aged ≥18 years were selected. Three consecutive blood pressure (BP) readings were measured after resting for a 5 min seat by trained staff and HTN was defined as mean systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg and/or self-reported current use of antihypertensive drugs. Participants were interviewed using a structured questionnaire. Anthropometric details, BP, blood and urine samples were also collected.Primary outcome measurePrevalence of HTN.ResultsOverall, the weighted prevalence of HTN among residents in Shenzhen was 19.2% (95% CI 18.5 to 20.0). Among patients with HTN, 55.0% (95% CI 52.9 to 57.1) were aware of their condition and 44.9% (95% CI 42.8 to 47.1) were taking antihypertensive medications, but only 21.7% (95% CI 20.0 to 23.5) achieved BP control. Among those who knew their HTN, 81.7% (95% CI 79.3 to 83.8) were under treatment and 48.3% (95% CI 45.1 to 51.5) were controlled among those with treated HTN. Male, older age, lower educational level, overweight and obesity, family history of HTN, tobacco smoking, alcohol intake, diabetes mellitus, dyslipidaemia and high uric acid were associated with HTN.ConclusionsHTN is a major public health concern in Shenzhen, which has low awareness, treatment and control rates, and is associated with several risk factors. Effective multifaceted implementation strategies are highly needed to combat the emerging burden of HTN.

Project description:OBJECTIVES:To investigate the prevalence of mild cognitive impairment and the relationship with plasma aluminium among aluminium workers. DESIGN:This was a cross-sectional case-control study in the SH Aluminium Factory, China. SETTING:The university and affiliated hospital cooperated in the study. PARTICIPANTS:There were 910 aluminium workers on duty, among whom 853 participated in our study. Participants, such as those with cerebral vascular disease, epilepsy, brain trauma, Parkinson's and mental diseases, aluminium-containing drug and mental drug use, and any family history of dementia in first-degree relatives were excluded. PRIMARY AND SECONDARY OUTCOME MEASURES:Blood samples were collected, and plasma aluminium was measured by inductively coupled plasma-mass spectrometry. For each case, four age-matched controls were evaluated to determine the relationship between aluminium exposure and mild cognitive impairment. Conditional logistic regression was used to explore influential factors in mild cognitive impairment. RESULTS:Among 910 workers, 93.74% participated in stage 1; 53 cases were finally diagnosed. The crude prevalence of mild cognitive impairment among aluminium workers on duty was 6.21%. There was a significant difference in plasma aluminium concentration between the two groups. In the multivariate analysis, we found that a higher level of plasma aluminium was associated with a high risk of cognitive impairment when compared with a lower aluminium level (AOR=2.24, 95% CI=1.17?to 4.26), and a high education level was a protective factor (AOR=0.36, 95% CI=0.18?to 0.70). No other factor was statistically significant. CONCLUSIONS:Mild cognitive impairment is no longer a disease specific to elderly people. High plasma aluminium exposure might be associated with an increased risk of cognitive impairment, but a reduced risk was observed with a high education level. The cognitive function of aluminium workers on duty must be considered seriously.

Dataset Information

Prevalence of post-stroke cognitive impairment in china: a community-based, cross-sectional study.

Publications

Prevalence of post-stroke cognitive impairment in china: a community-based, cross-sectional study.

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