Changes in Mini Mental State Examination score after stroke: lacunar infarction predicts cognitive decline

• Published in: European journal of neurology Vol. 13; no. 5; pp. 491 - 495
• Main Authors: Appelros, P., Andersson, Å. G.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.05.2006
• Subjects: Analysis of Variance; Brain - pathology; Brain - physiopathology; Cerebral Infarction - physiopathology; Cerebral Infarction - psychology; Cognition Disorders - epidemiology; Cognition Disorders - etiology; cognitive disorders; Dermatologi och venerologi, klinisk genetik, invärtesmedicin; Dermatology and venerology,clinical genetics, internal medicine; Female; Functional Laterality; Geriatrics; Geriatrics and medical gerontology; Geriatrik; Geriatrik och medicinsk gerontologi; Humans; Hypertension - mortality; Hypertension - physiopathology; Hypertension - psychology; Internal medicine; Invärtesmedicin; Male; MEDICIN; Medicin och hälsovetenskap; MEDICINE; Neurologi; Neurology; Neuropsychological Tests; prognosis; Risk Factors; stroke; Stroke - mortality; Stroke - physiopathology; Stroke - psychology; Survival Analysis
• ISSN: 1351-5101; 1468-1331; 1468-1331
• DOI: 10.1111/j.1468-1331.2006.01299.x

Stroke and cognitive impairment are inter‐related. The purpose of this study was to show the natural evolution of cognitive performance during the first year after a stroke, and to show which factors that predict cognitive decline. Subjects were patients with a first‐ever stroke who were treated in a stroke unit. A total of 160 patients were included. At baseline patients were evaluated with regard to stroke type, stroke severity, pre‐stroke dementia and other risk factors. Mini Mental State Examinations (MMSE) were performed after 1 week and after 1 year. Patients had a median increase of 1 point (range −8 to +9) on the MMSE. Thirty‐two pre cent of the patients deteriorated, 13% were unchanged, and 55% improved. Lacunar infarction (LI) and left‐sided stroke were associated with a failure to exhibit improvement. Patients with LI had an average decline of 1.7 points, whilst patients with other stroke types had an average increase of 1.8 points. Most stroke survivors improve cognitively during the first year after the event. The outcome for LI patients is worse, which suggests that LI may serve as a marker for concomitant processes that cause cognitive decline.