Study of Clinico-Radiological Risk Factors and Laboratory Parameters in Association with Post Stroke Vascular Cognitive Impairment
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 3
Abstract
Abstract: Cognitive impairment due to cerebrovascular disease is termed.” vascular cognitive Impairment “(vici,) and forms a spectrum that includes vascular dementia and milder forms of cognitive impairment referred to as vascular mild cognitive impairment (vci)1. Vascular cognitive impairment (vci) has some varied and diverse aetiology. This is particularly important as apart from age. Vascular risk factors are the most important and presently the only treatable precursor to dementia. This prospective observational study was carried out in in department of medicine, Gandhi medical College and associated Hamidia Hospital bhopal. This study covered population of bhopal and neighbouring districts. A standard protocol was applied at admission and 3 months after stroke, this protocol included clinical, functional and cognitive assessments, heamogram and serum biochemistry, ecg, non-contrast CT scan, 2d echo, carotid Doppler and MMSE (mini mental state examination). Mean age of patients having mild cognitive impairment is 63±6. In these study 62% patients belongs to low socioeconomic status. The percentage of patients having low socioeconomic status and low educational status is more in patients having vascular cognitive impairment. Amongst the various risk factors hypertension, diabetes mellitus, prior stroke, dyslipidemia, ischaemic heart disease, tobacco chewing, smoking family history of dementia were more frequently seen vascular cognitive impairment group. In this study, the frequency of patients having post stroke vascular cognitive impairment (VCI) is 54%. 18% of the patients had VaD(Vascular dementia), 36% of the patients had VMCI(vascular mild cognitive impairment), 46% of the patients had NO VCI (no vascular cognitive impairment. There was significant association of risk factors like Hypertension (p=0.022) diabetes mellitus (P=0.038), dyslipidaemia (p=0.034), prior stroke (p=0.046) with development of vascular cognitive impairment. To conclude, post-stroke cognitive impairment is commonly seen and is associated with considerable morbidity and poor functional outcome. Both ischemic and haemorrhagic stroke may result in cognitive impairment. The predictors of development of Vascular cognitive impairment following stroke in this study are lower educational status, Hypertension, Diabetes mellitus, Dyslipidaemia, Prior stroke, Urinary incontinence, High systolic blood pressure, NIHSS score, LDL level, abnormal ECG, Strategic site lesion and greater severity of age related white matter changes.
Authors and Affiliations
Dr. Anil Sejwar, Dr. Gopal Krishna, Dr. Arpit Dhiran
Keywords
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