Document Detail


The prognostic value of domain-specific cognitive abilities in acute first-ever stroke.
MedLine Citation:
PMID:  15753416     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the prognostic value of domain-specific cognitive abilities in acute stroke with respect to long-term cognitive and functional outcome in addition to neurologic and demographic predictors. METHODS: The authors evaluated 168 patients within the first 3 weeks after first-ever stroke. The prevalence of neuropsychological impairment was calculated vs 75 matched healthy controls. The authors also recorded demographic data, vascular risk factors, lesion characteristics, and clinical factors at admission. Independent predictor variables associated with long-term cognitive impairment (assessed with a follow-up neuropsychological examination) and functional impairment (assessed with the modified Barthel Index and the Frenchay Activities Index) were identified with stepwise multiple logistic regression. Areas under receiver operator characteristic curves were used to compare the predictive value of three models, i.e., a standard medical model, a purely cognitive model, and a model consisting of both medical and cognitive predictors. RESULTS: Thirty-one percent of patients showed long-term cognitive impairment. Basic and instrumental ADL disturbances remained present in 19% and 24% of patients. Domain-specific cognitive functioning predicted cognitive and functional outcome better than any other variable. Moreover, the prediction of instrumental ADL functioning improved when cognitive predictors were added to the standard medical model (p < 0.05). Impairments in abstract reasoning and executive functioning were independent predictors of long-term cognitive impairment. Inattention and perceptual disorders were more important in predicting long-term functional impairment. CONCLUSION: Domain-specific cognitive abilities in the early phase of stroke are excellent independent predictors of long-term cognitive and functional outcome.
Authors:
G M S Nys; M J E van Zandvoort; P L M de Kort; H B van der Worp; B P W Jansen; A Algra; E H F de Haan; L J Kappelle
Related Documents :
8717926 - Predictors of the use of memory improvement strategies by older adults.
22907206 - Phonological memory in bilinguals and monolinguals.
22416826 - Impaired memory and executive function associated with decreased medial temporal and pr...
22498896 - Bipolar disorder ank3 risk variant effect on sustained attention is replicated in a lar...
21942436 - Administration of dehydroepiandrosterone (dhea) enhances visual-spatial performance in ...
15562406 - Verbal selective learning after traumatic brain injury in children.
Publication Detail:
Type:  Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Neurology     Volume:  64     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-03-08     Completed Date:  2006-02-09     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  821-7     Citation Subset:  AIM; IM    
Affiliation:
Psychological Laboratory, Utrecht University, Heidelberglaan 2, 3584 CS Utrecht, The Netherlands. g.nys@fss.uu.nl
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Brain / blood supply,  pathology,  physiopathology*
Causality
Cognition / physiology*
Cognition Disorders / diagnosis*,  etiology,  psychology*
Diabetes Complications / physiopathology
Female
Humans
Hypercholesterolemia / complications,  physiopathology
Hypertension / complications,  physiopathology
Male
Middle Aged
Netherlands
Neuropsychological Tests / standards*
Predictive Value of Tests
Prognosis
Recovery of Function / physiology
Stroke / complications,  diagnosis*,  psychology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Timing of TIAs preceding stroke: time window for prevention is very short.
Next Document:  "Diffusion-clinical mismatch" is associated with potential for early recovery of aphasia.