dc.contributor.author | Schellhorn, Till | |
dc.contributor.author | Zucknick, Manuela | |
dc.contributor.author | Askim, Torunn | |
dc.contributor.author | Munthe-Kaas, Ragnhild | |
dc.contributor.author | Ihle-Hansen, Hege | |
dc.contributor.author | Seljeseth, Yngve Müller | |
dc.contributor.author | Knapskog, Anne Brita | |
dc.contributor.author | Næss, Halvor | |
dc.contributor.author | Ellekjær, Hanne | |
dc.contributor.author | Thingstad, Pernille | |
dc.contributor.author | Wyller, Torgeir Bruun | |
dc.contributor.author | Saltvedt, Ingvild | |
dc.contributor.author | Beyer, Mona Kristiansen | |
dc.date.accessioned | 2021-07-13T07:56:21Z | |
dc.date.available | 2021-07-13T07:56:21Z | |
dc.date.created | 2021-07-05T14:34:34Z | |
dc.date.issued | 2021 | |
dc.identifier.citation | BMC Geriatrics. 2021, 21 (362), . | en_US |
dc.identifier.issn | 1471-2318 | |
dc.identifier.uri | https://hdl.handle.net/11250/2764231 | |
dc.description.abstract | Background
Chronic brain pathology and pre-stroke cognitive impairment (PCI) is predictive of post-stroke dementia. The aim of the current study was to measure pre-stroke neurodegenerative and vascular disease burden found on brain MRI and to assess the association between pre-stroke imaging pathology and PCI, whilst also looking for potential sex differences.
Methods
This prospective brain MRI cohort is part of the multicentre Norwegian cognitive impairment after stroke (Nor-COAST) study. Patients hospitalized with acute ischemic or hemorrhagic stroke were included from five participating stroke units. Visual rating scales were used to categorize baseline MRIs (N = 410) as vascular, neurodegenerative, mixed, or normal, based on the presence of pathological imaging findings. Pre-stroke cognition was assessed by interviews of patients or caregivers using the Global Deterioration Scale (GDS). Stroke severity was assessed with the National Institute of Health Stroke Scale (NIHSS). Univariate and multiple logistic regression analyses were performed to investigate the association between imaging markers, PCI, and sex.
Results
Patients’ (N = 410) mean (SD) age was 73.6 (±11) years; 182 (44%) participants were female, the mean (SD) NIHSS at admittance was 4.1 (±5). In 68% of the participants, at least one pathological imaging marker was found. Medial temporal lobe atrophy (MTA) was present in 30% of patients, white matter hyperintensities (WMH) in 38% of patients and lacunes in 35% of patients. PCI was found in 30% of the patients. PCI was associated with cerebrovascular pathology (OR 2.5; CI = 1.4 to 4.5, p = 0.001) and mixed pathology (OR 3.4; CI = 1.9 to 6.1, p = 0.001) but was not associated with neurodegeneration (OR 1.0; CI = 0.5 to 2.2; p = 0.973). Pathological MRI markers, including MTA and lacunes, were more prevalent among men, as was a history of clinical stroke prior to the index stroke. The OR of PCI for women was not significantly increased (OR 1.2; CI = 0.8 to 1.9; p = 0.3).
Conclusions
Pre-stroke chronic brain pathology is common in stroke patients, with a higher prevalence in men. Vascular pathology and mixed pathology are associated with PCI. There were no significant sex differences for the risk of PCI. | en_US |
dc.language.iso | eng | en_US |
dc.publisher | BioMed Central Ltd. | en_US |
dc.rights | Navngivelse 4.0 Internasjonal | * |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/deed.no | * |
dc.title | Pre-stroke cognitive impairment is associated with vascular imaging pathology: a prospective observational study | en_US |
dc.type | Peer reviewed | en_US |
dc.type | Journal article | en_US |
dc.description.version | publishedVersion | en_US |
dc.source.volume | 21 | en_US |
dc.source.journal | BMC Geriatrics | en_US |
dc.source.issue | 362 | en_US |
dc.identifier.doi | 10.1186/s12877-021-02327-2 | |
dc.identifier.cristin | 1920330 | |
dc.description.localcode | Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. | en_US |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 1 | |