Assessment of risk factors in post-stroke cognitive impairment

Abstract

Background: Cognitive impairment is a frequent symptom in post-stroke patients, with a prevalence range of 20% to 80%. Our study’s aim was to analyze the previously reported risk factors in order to highlight predictors of a poor prognosis in post-stroke cognitive impairment. Articles containing the key words: “cognitive impairment”, “stroke”, “risk factors” were selected from PubMed databases. The following filters were applied: article type – meta-analysis, review, systematic review; period of time – 5 years; language – English; species – humans; age – 45 – 65+ years. 46 results were identified, but only 20 articles were selected as relevant. Analyzing identified data, we found out that the following risk factors had a strong association with cognitive impairment after stroke – in 60 – 80% of cases: increased age, low educational status, vascular comorbidities, prior transient ischemic attack or recurrent stroke, depressive illness, cerebral atrophy, white matter lesions, alcohol use. Also, we identified other risk factors with a low association – in 20 – 30% of cases with cognitive impairment after stroke: family history, genetic variants, carotid plaques, smoking, paresis, elevated homocysteine, low-density lipoprotein, uric acid, low triiodothyronine syndrome, anemia, decreasing serum retinoic acid level, elevated serum rheumatoid factor and matrix metalloproteinases-9 levels. Conclusions: This literature review confirms the existence of studies with a high level of evidence on risk factors which trigger cognitive impairment in post-stroke patients. Acknowledgement of these risk factors could improve stroke management and rise these patients’ quality of life.