Assessment of cognitive functions in patients with metabolic syndrome after ischemic stroke

Authors

  • N. Yu. Bachinskaya SI “Institute of Gerontology named after D. F. Chebotarev of NAMS of Ukraine”, Kyiv,
  • O. O. Kopchak SI “Institute of Gerontology named after D. F. Chebotarev of NAMS of Ukraine”, Kyiv,

DOI:

https://doi.org/10.14739/2310-1210.2018.02.124817

Keywords:

cognitive dysfunction, metabolic syndrome

Abstract

Post-stroke cognitive impairment (PSCI) occupies a prominent position among cognitive impairment associated with vascular brain pathology.

The purpose – to assess cognitive functions in patients with the history of ischemic stroke, depending on the metabolic syndrome (MS) presence and to determine the peculiarities of cognitive functions dynamics in the early recovery period after ischemic stroke in the anterior circulation area in patients with and without metabolic syndrome depending on ischemic lesion localization.

Materials and methods. There were 122 patients in the early recovery period after ischemic stroke enrolled into the study. Depending on the MS presence, patients with the history of ischemic stroke were divided into 2 groups: with MS (n = 72) and without MS (n = 50). All the patients were divided into 3 age subgroups: 45 – 59 years – middle age, 60 – 74 years – elderly, 75 – 89 years - senile age. All patients had general clinical, neuropsychological examination, laboratory tests; MRI of the brain.

Results. There was no significant difference among patients of the main clinical groups on the frequency of pre-mild and mild cognitive impairment; however the incidence of post-stroke dementia was significantly higher among patients with MS comparing with those without MS. There was significant augmentation of PSCI severity with age in patients with MS and without it. According to the results of neuropsychological tests, the best cognitive functions recovery in 6 months after the stroke (in the early recovery period) was observed in patients without MS, especially in the cases of left hemisphere ischemic lesions.

Conclusions. Patients with MS had significantly more pronounced PSCI than patients without MS. The increase in age had a negative effect on the PSCI severity both in patients with and without metabolic syndrome. The presence of MS worsened the process of cognitive functions restoration in patients with PSCI.

References

Mishchenko, T. S. (2014). Sosudistaya demenciya (evolyuciya vzglyadov na problemu) [Vascular dementia (the evolution of views on the problem)]. Ukrainskyi visnyk psykhonevrolohii, 22(1), 5–10. [in Russian]

Levin, O. S., Dudarova, M. A., & Usol'ceva, N. I. (2010). Diagnostika i lechenie postinsul'tnykh kognitivnykh narushenij [Diagnosis and treatment of post-stroke cognitive impairment]. Сonsilium medicum, 12(2), 5–12. [in Russian]

Kim, J. H., Go, S. M., Seo, S. W., Kim, S. H., Chin, J., Moon, S. Y., et al. (2015). Survival in Subcortical Vascular Dementia: Predictors and Comparison to Probable Alzheimer's Disease in a Tertiary Memory Clinic Population. J. Dement. Geriatr. Cogn. Disord., 40(3–4), 210–221. doi: 10.1159/000434626.

Liu, M., He, Y., Jiang, B., Wu, L., Wang, J., Yang, S., & Wang, Y. (2015). Association between metabolic syndrome and mild cognitive impairment and its age difference in a Chinese community elderly population. Clinical endocrinology, 82(6), 844–53. doi: 10.1111/cen.12734.

Kopchak, O. (2014). Diabetes mellitus and cognition in patients with metabolic syndrome. Wiadomosci Lekarskie, 67(4), 443–446.

Korkushko, O. V., Kopchak, O. O., Shatilo, V. B., & Bachinskaya, N. U. (2015). Metabolicheskij sindrom i kognitivnye narusheniya u bol'nykh starshego vozrasta s distsirkulyatornoj encefalopatiej [Metabolic syndrome and cognitive impairment in aging patients with dyscirculatory encephalopathy]. Uspekhi gerontologii, 28(3), 546–554. [in Russian]

Li, P., Quan, W., Lu, Da, Wang, Y., Zhang, H-H., Liu, Sh., et al. (2016). Association between Metabolic Syndrome and Cognitive Impairment after Acute Ischemic Stroke: A Cross-Sectional Study in a Chinese Populatio. PLOS One, 11(12), e0167327. doi: 10.1371/journal.pone.0167327.

Biller, J., Love, B. B., Marsh, E. E., Jones, M. P., Knepper, L. E., Jiang, D., et al. (1990). Spontaneous improvement after acute ischemic stroke A pilot study. Stroke, 21(7), 1008–1012.

Mahoney, F. L., & Barthel, D. W. (1965). Functional evaluation: The Barthel index. Md. State Med.J., 114, 61.

Mitchenko, O. I., & Karpachov, V. V. (2011). Diahnostyka i likuvannia metabolichnoho syndromu, tsukrovoho diabetu, prediabetu i sertsevo-sudynnykh zakhvoriuvan: rekomendatsii asotsiatsii kardiolohiv Ukrainy ta asotsiatsii endokrynolohiv Ukrainy [Diagnosis and treatment of metabolic syndrome, diabetes mellitus, prediabetes and cardiovascular diseases: recommendations of the association of cardiologists of Ukraine and the association of endocrinologists of Ukraine]. Sertsevo-sudynni zakhvoriuvannia: rekomendatsii z diahnostyky, profilaktyky ta likuvannia. ( V. M. Kovalenko, M.I. Lutaj, eds.). (P. 68–79). Kyiv: Morion, [in Ukrainian]

Zakharov, V. V., & Yakhno, N. N. (2005). Kognitivnye rasstrojstva v pozhilom i starcheskom vozraste [Cognitive disorders in elderly and senile age]. Metodicheskoe posobie dlya vrachej. Moscow. [in Russian].

Petersen, R. C. (2004). Mild cognitive impairment as a diagnostic entity. J. Intern. Med., 256, 183–194. doi: 10.1111/j.1365-2796.2004.01388.x.

Folstein, M., Folstein, S., & McHugh, P. R. (1975). Mini-mental state: a practical method for grading the cognitive state of patients for the clinical. J. Psychiatr. Res., 12, 189–198.

Jorm, A. F. (2004). The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE): A review. Int. Psychogeriatr., 16, 275–93. doi: 10.1017/S1041610204000390.

Kopchak, O. O., Bachynska, N. Yu., & Kholyn, V. O. (2014). Vikovi osoblyvosti kohnityvnykh porushen u khvorykh z metabolichnym syndromom [Cognitive impairment in patients of different age with metabolic syndrome]. Wiadomosci Lekarskie, 67(2), 202–206. [in Ukrainian]

How to Cite

1.
Bachinskaya NY, Kopchak OO. Assessment of cognitive functions in patients with metabolic syndrome after ischemic stroke. Zaporozhye medical journal [Internet]. 2018Mar.7 [cited 2024Apr.20];(2). Available from: http://zmj.zsmu.edu.ua/article/view/124817

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Section

Original research