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 Kohler; Elles Douven; Julie Staals; Christopher Chen; Xin Xu; Eddie J. Chong; Rufus O. Akinyemi; Rajesh N. Kalaria; Adesola Ogunniyi; Melanie 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; Regis Bordet; Stephanie Bombois; Hilde Henon; Darren M. Lipnicki; Nicole A. Kochan; Perminder S. Sachdev; Amy Brodtmann; Aleksandra Klimkowicz-Mrowiec; Martin Dichgans; Michael Hoffmann; Thomas Linden; Joanna Wardlaw; Charlotte Cordonnier; Vincent Mok; Stroke and Cognition (STROKOG) Collaboration

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 Kohler, Elles Douven, Julie Staals, Christopher Chen, Xin Xu, Eddie J. Chong, Rufus O. Akinyemi, Rajesh N. Kalaria, Adesola Ogunniyi, Melanie 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, Regis Bordet, Stephanie Bombois, Hilde Henon, Darren M. Lipnicki, Nicole A. Kochan, Perminder S. Sachdev^*, Amy Brodtmann, Aleksandra Klimkowicz-Mrowiec, Martin Dichgans, Michael Hoffmann, Thomas Linden, Joanna Wardlaw, Charlotte Cordonnier, Vincent Mok, Stroke and Cognition (STROKOG) Collaboration

^*Corresponding author for this work

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

49 Citations (Web of Science)

Abstract

Objective

To 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.

Methods

We 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.

Results

In 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.

Conclusions

This 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
Pages (from-to)	E2257-E2271
Number of pages	15
Journal	Neurology
Volume	93
Issue number	24
DOIs	https://doi.org/10.1212/WNL.0000000000008612
Publication status	Published - 10 Dec 2019

Keywords

INDIVIDUAL PARTICIPANT DATA
DEMENTIA
STROKE
METAANALYSIS
HYPERTENSION
STATEMENT

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10.1212/WNL.0000000000008612Licence: CC BY-NC-ND

Cite this

Lo, J. W., Crawford, J. D., Desmond, D. W., Godefroy, O., Jokinen, H., Mahinrad, S., Bae, H-J., Lim, J-S., Kohler, S., Douven, E., Staals, J., Chen, C., Xu, X., Chong, E. J., Akinyemi, R. O., Kalaria, R. N., Ogunniyi, A., Barbay, M., Roussel, M., ... Stroke and Cognition (STROKOG) Collaboration (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{46e88c4ecb2f4cfa89a3c561346b44d0,

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.",

keywords = "INDIVIDUAL PARTICIPANT DATA, DEMENTIA, STROKE, METAANALYSIS, HYPERTENSION, STATEMENT",

author = "Lo, {Jessica W.} and Crawford, {John D.} and Desmond, {David W.} and Olivier Godefroy and Hanna Jokinen and Simin Mahinrad and Hee-Joon Bae and Jae-Sung Lim and Sebastian Kohler 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 Melanie Barbay and Martine Roussel and Byung-Chul Lee 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 Regis Bordet and Stephanie Bombois and Hilde Henon and Lipnicki, {Darren M.} and Kochan, {Nicole A.} and Sachdev, {Perminder S.} and Amy Brodtmann and Aleksandra Klimkowicz-Mrowiec and Martin Dichgans and Michael Hoffmann and Thomas Linden and Joanna Wardlaw and Charlotte Cordonnier and Vincent Mok and {Stroke and Cognition (STROKOG) Collaboration}",

year = "2019",

month = dec,

day = "10",

doi = "10.1212/WNL.0000000000008612",

language = "English",

volume = "93",

pages = "E2257--E2271",

journal = "Neurology",

issn = "0028-3878",

publisher = "LIPPINCOTT WILLIAMS & WILKINS",

number = "24",

}

Lo, JW, Crawford, JD, Desmond, DW, Godefroy, O, Jokinen, H, Mahinrad, S, Bae, H-J, Lim, J-S, Kohler, S, Douven, E, Staals, J, Chen, C, Xu, X, Chong, EJ, Akinyemi, RO, Kalaria, RN, Ogunniyi, A, Barbay, M, Roussel, M, Lee, B-C, Srikanth, VK, Moran, C, Kandiah, N, Chander, RJ, Sabayan, B, Jukema, JW, Melkas, S, Erkinjuntti, T, Brodaty, H, Bordet, R, Bombois, S, Henon, H, Lipnicki, DM, Kochan, NA, Sachdev, PS, Brodtmann, A, Klimkowicz-Mrowiec, A, Dichgans, M, Hoffmann, M, Linden, T, Wardlaw, J, Cordonnier, C, Mok, V & Stroke and Cognition (STROKOG) Collaboration 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 - Kohler, 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, Melanie

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, Regis

AU - Bombois, Stephanie

AU - Henon, Hilde

AU - Lipnicki, Darren M.

AU - Kochan, Nicole A.

AU - Sachdev, Perminder S.

AU - Brodtmann, Amy

AU - Klimkowicz-Mrowiec, Aleksandra

AU - Dichgans, Martin

AU - Hoffmann, Michael

AU - Linden, Thomas

AU - Wardlaw, Joanna

AU - Cordonnier, Charlotte

AU - Mok, Vincent

AU - Stroke and Cognition (STROKOG) Collaboration

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.

KW - INDIVIDUAL PARTICIPANT DATA

KW - DEMENTIA

KW - STROKE

KW - METAANALYSIS

KW - HYPERTENSION

KW - STATEMENT

U2 - 10.1212/WNL.0000000000008612

DO - 10.1212/WNL.0000000000008612

M3 - Article

C2 - 31712368

VL - 93

SP - E2257-E2271

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 24

ER -