Published Online
on April 17, 2003

A more recent version of this article appeared on May 1, 2003

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Submitted on November 29, 2002
Accepted on December 10, 2002

Increased Risk of Cognitive Impairment 3 Months After Mild to Moderate First-Ever Stroke. A Community-Based Prospective Study of Nonaphasic English-Speaking Survivors

Velandai K. Srikanth PhD^*; Amanda G. Thrift PhD; Michael M. Saling PhD; Jacqueline F.I. Anderson BSc; Helen M. Dewey PhD; Richard A.L. Macdonell MD; and Geoffrey A. Donnan MD

From the Epidemiology Division, National Stroke Research Institute, Austin & Repatriation Medical Center (V.K.S., A.G.T., H.M.D., R.A.L.M., G.A.D.), and Department of Neuropsychology, University of Melbourne, Parkville (M.M.S., J.F.I.A.), Melbourne, Australia.

^* To whom correspondence should be addressed. E-mail: velandai.srikanth{at}utas.edu.au.

Background and Purpose--Results of hospital-based studies indicate a high risk of cognitive impairment 3 months after stroke. There are no comprehensive data on this issue from prospective community-based studies comparing first-ever stroke patients with stroke-free subjects.

Methods--We administered a comprehensive neuropsychological battery to 99 community-based nonaphasic survivors of first-ever stroke at 3 months and 99 age- and sex-matched (1:1) stroke-free individuals. Domain-specific cognitive deficits were identified by blinded neuropsychological consensus.

Methods--Stroke patients were more likely to suffer any cognitive impairment (relative risk [RR], 1.5; 95% CI, 1.1 to 2.1) attributable mainly to a greater risk of single-domain cognitive impairment (RR, 2.8; 95% CI, 1.5 to 5.3) but not multiple-domain cognitive impairment (RR, 1.2; 95% CI, 0.8 to 1.9).

Conclusions--In this community-based study, a first-ever stroke of mild to moderate severity was associated with a significant risk of cognitive impairment at 3 months, even in the absence of clinical aphasia. This was due primarily to an increased risk of solitary deficits rather than generalized deficits.

Key words: cognition • dementia • epidemiology • stroke

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