Profile of and risk factors for poststroke cognitive impairment in diverse ethnoregional groups

Jessica W. Lo; John D. Crawford; David W. Desmond; Olivier Godefroy; Hanna Jokinen; Simin Mahinrad; Hee Joon Bae; Jae Sung Lim; Sebastian Köhler; Elles Douven; Julie Staals; Christopher Chen; Xin Xu; Eddie J. Chong; Rufus O. Akinyemi; Rajesh N. Kalaria; Adesola Ogunniyi; Mélanie Barbay; Martine Roussel; Byung Chul Lee; Velandai K. Srikanth; Christopher Moran; Nagaendran Kandiah; Russell J. Chander; Behnam Sabayan; J. Wouter Jukema; Susanna Melkas; Timo Erkinjuntti; Henry Brodaty; Régis Bordet; Stéphanie Bombois; Hilde Hénon; Darren M. Lipnicki; Nicole A. Kochan; Perminder S. Sachdev

doi:10.1212/WNL.0000000000008612

Profile of and risk factors for poststroke cognitive impairment in diverse ethnoregional groups

Jessica W. Lo, John D. Crawford, David W. Desmond, Olivier Godefroy, Hanna Jokinen, Simin Mahinrad, Hee Joon Bae, Jae Sung Lim, Sebastian Köhler, Elles Douven, Julie Staals, Christopher Chen, Xin Xu, Eddie J. Chong, Rufus O. Akinyemi, Rajesh N. Kalaria, Adesola Ogunniyi, Mélanie Barbay, Martine Roussel, Byung Chul LeeVelandai K. Srikanth, Christopher Moran, Nagaendran Kandiah, Russell J. Chander, Behnam Sabayan, J. Wouter Jukema, Susanna Melkas, Timo Erkinjuntti, Henry Brodaty, Régis Bordet, Stéphanie Bombois, Hilde Hénon, Darren M. Lipnicki, Nicole A. Kochan, Perminder S. Sachdev^*

^*Corresponding author for this work

Neurology

Research output: Contribution to journal › Article › peer-review

185 Scopus citations

Abstract

ObjectiveTo address the variability in prevalence estimates and inconsistencies in potential risk factors for poststroke cognitive impairment (PSCI) using a standardized approach and individual participant data (IPD) from international cohorts in the Stroke and Cognition Consortium (STROKOG) consortium.MethodsWe harmonized data from 13 studies based in 8 countries. Neuropsychological test scores 2 to 6 months after stroke or TIA and appropriate normative data were used to calculate standardized cognitive domain scores. Domain-specific impairment was based on percentile cutoffs from normative groups, and associations between domain scores and risk factors were examined with 1-stage IPD meta-analysis.ResultsIn a combined sample of 3,146 participants admitted to hospital for stroke (97%) or TIA (3%), 44% were impaired in global cognition and 30% to 35% were impaired in individual domains 2 to 6 months after the index event. Diabetes mellitus and a history of stroke were strongly associated with poorer cognitive function after covariate adjustments; hypertension, smoking, and atrial fibrillation had weaker domain-specific associations. While there were no significant differences in domain impairment among ethnoracial groups, some interethnic differences were found in the effects of risk factors on cognition.ConclusionsThis study confirms the high prevalence of PSCI in diverse populations, highlights common risk factors, in particular diabetes mellitus, and points to ethnoracial differences that warrant attention in the development of prevention strategies.

Original language	English (US)
Pages (from-to)	E2257-E2271
Journal	Neurology
Volume	93
Issue number	24
DOIs	https://doi.org/10.1212/WNL.0000000000008612
State	Published - Dec 10 2019

Funding

J. Lo reports grants from Vincent Fairfax. J. Crawford and D. Desmond report no disclosures relevant to the manuscript. O. Godefroy reports grants from DGOS French (health department). H. Jokinen reports grants from the Clinical Research Institute and the Medical Research Fund of the Helsinki University Hospital. S. Mahinrad, H. Bae, J. Lim, S. Köhler, E. Douven, and J. Staals report no disclosures relevant to the manuscript. C. Chen reports grants from National Medical Research Council of Singapore during the conduct of the study. X. Xu, E. Chong, R. Akinyemi, R. Kalaria, A. Ogunniyi, M. Barbay, M. Roussel, B. Lee, V. Srikanth, C. Moran, N. Kandiah, R. Chander, B. Sabayan, J. Jukema, S. Melkas, T. Erkinjuntti, H. Brodaty, R. Bordet, S. Bombois, H. Hénon, and D. Lipnicki report no disclosures relevant to the manuscript. N. Kochan reports grants from National Health and Medical Research Council Early Career Fellowship (RG123148). P. Sachdev is on the Advisory Board of Biogen Australia. Go to Neurology.org/N for full disclosures. This work was supported by the Vincent Fairfax Family Foundation (Australia) and the National Health and Medical Research Council of Australia Program Grant. Funding information for individual studies is available from Dryad (appendix T20, doi.org/10.5061/dryad.m517990).

ASJC Scopus subject areas

Clinical Neurology

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10.1212/WNL.0000000000008612

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Lo, J. W., Crawford, J. D., Desmond, D. W., Godefroy, O., Jokinen, H., Mahinrad, S., Bae, H. J., Lim, J. S., Köhler, S., Douven, E., Staals, J., Chen, C., Xu, X., Chong, E. J., Akinyemi, R. O., Kalaria, R. N., Ogunniyi, A., Barbay, M., Roussel, M., ... Sachdev, P. S. (2019). Profile of and risk factors for poststroke cognitive impairment in diverse ethnoregional groups. Neurology, 93(24), E2257-E2271. https://doi.org/10.1212/WNL.0000000000008612

@article{12d6670c3dfe4fd5a728eff13ef4d5ba,

title = "Profile of and risk factors for poststroke cognitive impairment in diverse ethnoregional groups",

abstract = "ObjectiveTo address the variability in prevalence estimates and inconsistencies in potential risk factors for poststroke cognitive impairment (PSCI) using a standardized approach and individual participant data (IPD) from international cohorts in the Stroke and Cognition Consortium (STROKOG) consortium.MethodsWe harmonized data from 13 studies based in 8 countries. Neuropsychological test scores 2 to 6 months after stroke or TIA and appropriate normative data were used to calculate standardized cognitive domain scores. Domain-specific impairment was based on percentile cutoffs from normative groups, and associations between domain scores and risk factors were examined with 1-stage IPD meta-analysis.ResultsIn a combined sample of 3,146 participants admitted to hospital for stroke (97%) or TIA (3%), 44% were impaired in global cognition and 30% to 35% were impaired in individual domains 2 to 6 months after the index event. Diabetes mellitus and a history of stroke were strongly associated with poorer cognitive function after covariate adjustments; hypertension, smoking, and atrial fibrillation had weaker domain-specific associations. While there were no significant differences in domain impairment among ethnoracial groups, some interethnic differences were found in the effects of risk factors on cognition.ConclusionsThis study confirms the high prevalence of PSCI in diverse populations, highlights common risk factors, in particular diabetes mellitus, and points to ethnoracial differences that warrant attention in the development of prevention strategies.",

author = "Lo, {Jessica W.} and Crawford, {John D.} and Desmond, {David W.} and Olivier Godefroy and Hanna Jokinen and Simin Mahinrad and Bae, {Hee Joon} and Lim, {Jae Sung} and Sebastian K{\"o}hler and Elles Douven and Julie Staals and Christopher Chen and Xin Xu and Chong, {Eddie J.} and Akinyemi, {Rufus O.} and Kalaria, {Rajesh N.} and Adesola Ogunniyi and M{\'e}lanie Barbay and Martine Roussel and Lee, {Byung Chul} and Srikanth, {Velandai K.} and Christopher Moran and Nagaendran Kandiah and Chander, {Russell J.} and Behnam Sabayan and Jukema, {J. Wouter} and Susanna Melkas and Timo Erkinjuntti and Henry Brodaty and R{\'e}gis Bordet and St{\'e}phanie Bombois and Hilde H{\'e}non and Lipnicki, {Darren M.} and Kochan, {Nicole A.} and Sachdev, {Perminder S.}",

note = "Publisher Copyright: {\textcopyright} 2019 American Academy of Neurology.",

year = "2019",

month = dec,

day = "10",

doi = "10.1212/WNL.0000000000008612",

language = "English (US)",

volume = "93",

pages = "E2257--E2271",

journal = "Neurology",

issn = "0028-3878",

publisher = "Lippincott Williams and Wilkins",

number = "24",

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Lo, JW, Crawford, JD, Desmond, DW, Godefroy, O, Jokinen, H, Mahinrad, S, Bae, HJ, Lim, JS, Köhler, S, Douven, E, Staals, J, Chen, C, Xu, X, Chong, EJ, Akinyemi, RO, Kalaria, RN, Ogunniyi, A, Barbay, M, Roussel, M, Lee, BC, Srikanth, VK, Moran, C, Kandiah, N, Chander, RJ, Sabayan, B, Jukema, JW, Melkas, S, Erkinjuntti, T, Brodaty, H, Bordet, R, Bombois, S, Hénon, H, Lipnicki, DM, Kochan, NA & Sachdev, PS 2019, 'Profile of and risk factors for poststroke cognitive impairment in diverse ethnoregional groups', Neurology, vol. 93, no. 24, pp. E2257-E2271. https://doi.org/10.1212/WNL.0000000000008612

TY - JOUR

T1 - Profile of and risk factors for poststroke cognitive impairment in diverse ethnoregional groups

AU - Lo, Jessica W.

AU - Crawford, John D.

AU - Desmond, David W.

AU - Godefroy, Olivier

AU - Jokinen, Hanna

AU - Mahinrad, Simin

AU - Bae, Hee Joon

AU - Lim, Jae Sung

AU - Köhler, Sebastian

AU - Douven, Elles

AU - Staals, Julie

AU - Chen, Christopher

AU - Xu, Xin

AU - Chong, Eddie J.

AU - Akinyemi, Rufus O.

AU - Kalaria, Rajesh N.

AU - Ogunniyi, Adesola

AU - Barbay, Mélanie

AU - Roussel, Martine

AU - Lee, Byung Chul

AU - Srikanth, Velandai K.

AU - Moran, Christopher

AU - Kandiah, Nagaendran

AU - Chander, Russell J.

AU - Sabayan, Behnam

AU - Jukema, J. Wouter

AU - Melkas, Susanna

AU - Erkinjuntti, Timo

AU - Brodaty, Henry

AU - Bordet, Régis

AU - Bombois, Stéphanie

AU - Hénon, Hilde

AU - Lipnicki, Darren M.

AU - Kochan, Nicole A.

AU - Sachdev, Perminder S.

PY - 2019/12/10

Y1 - 2019/12/10

N2 - ObjectiveTo address the variability in prevalence estimates and inconsistencies in potential risk factors for poststroke cognitive impairment (PSCI) using a standardized approach and individual participant data (IPD) from international cohorts in the Stroke and Cognition Consortium (STROKOG) consortium.MethodsWe harmonized data from 13 studies based in 8 countries. Neuropsychological test scores 2 to 6 months after stroke or TIA and appropriate normative data were used to calculate standardized cognitive domain scores. Domain-specific impairment was based on percentile cutoffs from normative groups, and associations between domain scores and risk factors were examined with 1-stage IPD meta-analysis.ResultsIn a combined sample of 3,146 participants admitted to hospital for stroke (97%) or TIA (3%), 44% were impaired in global cognition and 30% to 35% were impaired in individual domains 2 to 6 months after the index event. Diabetes mellitus and a history of stroke were strongly associated with poorer cognitive function after covariate adjustments; hypertension, smoking, and atrial fibrillation had weaker domain-specific associations. While there were no significant differences in domain impairment among ethnoracial groups, some interethnic differences were found in the effects of risk factors on cognition.ConclusionsThis study confirms the high prevalence of PSCI in diverse populations, highlights common risk factors, in particular diabetes mellitus, and points to ethnoracial differences that warrant attention in the development of prevention strategies.

AB - ObjectiveTo address the variability in prevalence estimates and inconsistencies in potential risk factors for poststroke cognitive impairment (PSCI) using a standardized approach and individual participant data (IPD) from international cohorts in the Stroke and Cognition Consortium (STROKOG) consortium.MethodsWe harmonized data from 13 studies based in 8 countries. Neuropsychological test scores 2 to 6 months after stroke or TIA and appropriate normative data were used to calculate standardized cognitive domain scores. Domain-specific impairment was based on percentile cutoffs from normative groups, and associations between domain scores and risk factors were examined with 1-stage IPD meta-analysis.ResultsIn a combined sample of 3,146 participants admitted to hospital for stroke (97%) or TIA (3%), 44% were impaired in global cognition and 30% to 35% were impaired in individual domains 2 to 6 months after the index event. Diabetes mellitus and a history of stroke were strongly associated with poorer cognitive function after covariate adjustments; hypertension, smoking, and atrial fibrillation had weaker domain-specific associations. While there were no significant differences in domain impairment among ethnoracial groups, some interethnic differences were found in the effects of risk factors on cognition.ConclusionsThis study confirms the high prevalence of PSCI in diverse populations, highlights common risk factors, in particular diabetes mellitus, and points to ethnoracial differences that warrant attention in the development of prevention strategies.

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U2 - 10.1212/WNL.0000000000008612

DO - 10.1212/WNL.0000000000008612

M3 - Article

C2 - 31712368

AN - SCOPUS:85076327660

SN - 0028-3878

VL - 93

SP - E2257-E2271

JO - Neurology

JF - Neurology

IS - 24

ER -

Profile of and risk factors for poststroke cognitive impairment in diverse ethnoregional groups

Abstract

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UN SDGs

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