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(Stroke. 2003;34:1136.)
© 2003 American Heart Association, Inc.

Original Contributions

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 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.

Correspondence to Dr Velandai K. Srikanth, Menzies Centre for Population Health Research, 17 Liverpool St, Hobart, Tasmania, Australia. 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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