Influencing factors of post-stroke cognitive impairment

doi:10.3760/cma.j.issn.1007-1245.2022.01.004

Abstract

Abstract: Post-stroke cognitive impairment (PSCI) seriously affects the patients' quality of life and prognosis and brings loads of burden to their families and the society. PSCI is reversible in early stage, so interventions should be done to improve their cognitive function. This article reviews the progresses on the influencing evaluation tools, epidemiology, and factors of PSCI, including demographic factors, disease factors, lifestyles, and mental disorders, so as to provide references for developing prevention and interventions of PSCI.

Key words: Stroke, Cognitive impairment, Influencing factors

摘要： 脑卒中后并发认知功能障碍严重影响患者的生活质量和疾病预后，增加了家庭和社会负担。脑卒中后认知障碍具有可逆性，早期干预可以改善认知功能。本文归纳总结了脑卒中后认知障碍的评估工具和流行病学，重点综述了影响因素，包括人口学因素、疾病相关因素、生活方式、情绪障碍4个方面，以期为脑卒中后认知障碍的预防及干预提供理论依据

关键词: 脑卒中, 认知障碍, 影响因素

Ji Haiyan, Tang Qingrong, Qiao Jubo. Influencing factors of post-stroke cognitive impairment[J]. International Medicine and Health Guidance News, 2022, 28(1): 15-18.

纪海燕, 唐庆蓉, 乔巨波. 脑卒中后认知障碍影响因素的研究进展[J]. 国际医药卫生导报, 2022, 28(1): 15-18.

References

[1] 中国脑卒中防治报告»编写组. «中国脑卒中防治报告2019»概要[J]. 中国脑血管病杂志,2020(5). DOI:10.3969/j.issn.1672-5921.2020.05.008.

[2] 汪凯,董强. 卒中后认知障碍管理专家共识2021[J]. 中国卒中杂志,2021(4). DOI:10.3969/j.issn.1673-5765. 2021. 04.011.

[3] Kwon HS, Lee D, Lee MH, et al. Post-stroke cognitive impairment as an independent predictor of ischemic stroke recurrence: PICASSO sub-study [J]. J Neurol, 2020, 267(3): 688-693. DOI: 10.1007/s00415-019-09630-4.

[4] 张彩迪,杨璧西,陆媛,等. 常见老年认知功能筛查量表的应用评述[J]. 上海预防医学,2018(4). DOI:10.19428/j.cnki.sjpm.2018.18806.

[5] Tsai CF, Lee WJ, Wang SJ, et al. Psychometrics of the Montreal Cognitive Assessment (MoCA) and its subscales: validation of the Taiwanese version of the MoCA and an item response theory analysis [J]. Int Psychogeriatr, 2012, 24(4): 651-658. DOI: 10.1017/S1041610211002298.

[6] Shi D, Chen X, Li Z. Diagnostic test accuracy of the Montreal Cognitive Assessment in the detection of post-stroke cognitive impairment under different stages and cutoffs: a systematic review and meta-analysis [J]. Neurol Sci, 2018, 39(4): 705-716. DOI: 10.1007/s10072-018-3254-0.

[7] Wong A, Law LS, Liu W, et al. Montreal Cognitive Assessment: one cutoff never fits all [J]. Stroke, 2015, 46(12): 3547-3550. DOI: 10.1161/STROKEAHA.115. 011226.

[8] Carson N, Leach L, Murphy KJ. A re-examination of Montreal Cognitive Assessment (MoCA) cutoff scores [J]. Int J Geriatr Psychiatry, 2018, 33(2): 379-388. DOI: 10.1002/gps.4756.

[9] Lees R, Selvarajah J, Fenton C, et al. Test accuracy of cognitive screening tests for diagnosis of dementia and multidomain cognitive impairment in stroke [J]. Stroke, 2014, 45(10): 3008-3018. DOI: 10.1161/STROKEAHA. 114.005842.

[10] 方云华,陈善佳,周小炫,等. MoCA、MMSE、NCSE等6个脑卒中认知康复评价工具的使用现状调查[J]. 中国康复,2014, 29(1). DOI:10.3870/zgkf.2014.01.012.

[11] Sun JH, Tan L, Yu JT. Post-stroke cognitive impairment: epidemiology, mechanisms and management [J]. Ann Transl Med, 2014, 2(8): 80. DOI: 10.3978/j.issn.2305- 5839. 2014.08.05.

[12] Donnellan C, Werring D. Cognitive impairment before and after intracerebral haemorrhage: a systematic review [J]. Neurol Sci, 2020, 41(3): 509-527. DOI: 10.1007/s10072- 019 -04150-5.

[13] Oh H, Park J, Seo W. A 2-year prospective follow-up study of temporal changes associated with post-stroke cognitive impairment [J]. Int J Nurs Pract, 2018, 24(2): e12618. DOI: 10.1111/ijn.12618.

[14] 张通,王强. 卒中后认知障碍的康复治疗[J]. 华西医学,2019, 34(5). DOI:10.7507/1002-0179.201903243.

[15] Kalaria RN, Akinyemi R, Ihara M. Stroke injury, cognitive impairment and vascular dementia [J]. Biochim Biophys Acta, 2016, 1862(5): 915-925. DOI: 10.1016/j.bbadis. 2016.01.015.

[16] 张君琴,张国新,张振涛.急性缺血性脑卒中后认知障碍的危险因素分析[J].中风与神经疾病杂志,2021,38(1):32-35. DOI:10.19845/j.cnki.zfysjjbzz.2021.0007

[17] Shiekh SI, Forbes H, Mathur R, et al. Ethnicity and risk of diagnosed dementia after stroke: a cohort study using the Clinical Practice Research Datalink [J]. J Epidemiol Community Health, 2020, 74(2): 114-119. DOI: 10.1136/jech-2019-212825.

[18] Suda S, Nishimura T, Ishiwata A, et al. Early cognitive impairment after minor stroke: associated factors and functional outcome [J]. J Stroke Cerebrovasc Dis, 2020, 29(5): 104749. DOI: 10.1016/j.jstrokecerebrovasdis. 2020.104749.

[19] Shin M, Sohn MK, Lee J, et al. Effect of cognitive reserve on risk of cognitive impairment and recovery after stroke: the KOSCO study [J]. Stroke, 2020, 51(1): 99-107. DOI: 10.1161/STROKEAHA.119.026829.

[20] 刘永珍,尹静,赵翠竹,等. 急性期首发脑卒中后抑郁状态与认知功能障碍的相关危险因素研究[J]. 中华老年心脑血管病杂志,2018,20(4):353-357. DOI:10.3969/j.issn.1009- 0126.2018.04.005.

[21] Lisabeth LD, Sánchez BN, Baek J, et al. Neurological, functional, and cognitive stroke outcomes in Mexican Americans [J]. Stroke, 2014, 45(4): 1096-1101. DOI: 10.1161/STROKEAHA.113.003912.

[22] Shiekh SI, Forbes H, Mathur R, et al. Ethnicity and risk of diagnosed dementia after stroke: a cohort study using the Clinical Practice Research Datalink [J]. J Epidemiol Community Health, 2020, 74(2): 114-119. DOI: 10.1136/jech-2019-212825.

[23] Lo JW, Crawford JD, Desmond DW, et al. Profile of and risk factors for poststroke cognitive impairment in diverse ethnoregional groups [J]. Neurology, 2019, 93(24): e2257-e2271. DOI: 10.1212/WNL.0000000000008612.

[24] Tadic M, Cuspidi C, Hering D. Hypertension and cognitive dysfunction in elderly: blood pressure management for this global burden [J]. BMC Cardiovasc Disord, 2016, 16(1): 208. DOI: 10.1186/s12872-016-0386-0.

[25] 张洁,李伟,张亚红,等.急性缺血性脑卒中后患者认知功能障碍的相关因素研究[J].中国临床神经科学,2019,27(3):259-266.

[26] 李倩倩. 急性缺血性脑卒中后认知功能障碍发病情况及相关因素的调查研究[D].太原:山西医科大学,2018.

[27] Lo JW, Crawford JD, Desmond DW, et al. Profile of and risk factors for poststroke cognitive impairment in diverse ethnoregional groups [J]. Neurology, 2019, 93(24):e2257-e2271. DOI: 10.1212/WNL.0000000000008612.

[28] Lee SH, Park SY, Jang MU, et al. Association between osteoporosis and cognitive impairment during the acute and recovery phases of ischemic stroke [J]. Medicina (Kaunas), 2020, 56(6): 307. DOI: 10.3390/medicina 56060307.

[29] 殷琪,许晋川,吕静美,等. 老年缺血性脑卒中后轻度血管性认知障碍的相关危险因素[J]. 中国老年学杂志,2014(16). DOI:10.3969/j.issn.1005-9202.2014.16.024.

[30] 曹颖,喻国,王意君,等. 探讨老年骨质疏松症与认知功能障碍的相关性[J]. 中华老年心脑血管病杂志,2021(3). DOI:10.3969/j.issn.1009-0126.2021.03.023.

[31] Zhang Y, Wang W, Cai S, et al. Obstructive sleep apnea exaggerates cognitive dysfunction in stroke patients [J]. Sleep Med, 2017, 33: 183-190. DOI: 10.1016/j.sleep.2016. 11.028.

[32] Li J, You SJ, Xu YN, et al. Cognitive impairment and sleep disturbances after minor ischemic stroke [J]. Sleep Breath, 2019, 23(2): 455-462. DOI: 10.1007/s11325-018- 1709-4.

[33] Gelber RP, Redline S, Ross GW, et al. Associations of brain lesions at autopsy with polysomnography features before death [J]. Neurology, 2015, 84(3): 296-303. DOI: 10.1212/WNL.0000000000001163.

[34] Arter JL, Chi DS, M G, et al. Obstructive sleep apnea, inflammation, and cardiopulmonary disease [J]. Front Biosci, 2004, 9: 2892-2900. DOI: 10.2741/1445.

[35] 杨陈丽,陈晶,李海燕,等. OSAHS与脑白质病变及认知障碍的相关性[J]. 青岛大学学报(医学版),2021(4). DOI:10.11712/jms.2096-5532.2021.57.065.

[36] 章瑞环,杨桂益. 缺血性脑卒中患者认知功能障碍与病灶部位的相关性分析[J]. 饮食保健,2017,4(4). DOI:10.3969/j.issn.2095-8439.2017.04.298.

[37] Pendlebury ST, Rothwell PM. Prevalence, incidence, and factors associated with pre-stroke and post-stroke dementia: a systematic review and meta-analysis [J]. Lancet Neurol, 2009, 8(11): 1006-1018. DOI: 10.1016/S1474-4422(09)70236-4.

[38] Kokmen E, Whisnant JP, O'Fallon WM, Chu CP, Beard CM. Dementia after ischemic stroke: a population-based study in Rochester, Minnesota (1960-1984) [J]. Neurology, 1996, 46(1): 154-159. DOI: 10.1212/wnl.46.1.154.

[39] 李黎.中高海拔地区脑卒中高危人群认知障碍筛查及影响因素分析[D].西宁: 青海大学, 2019.

[40] 陈永明,吕薇,张建明,等. 急性缺血性卒中患者认知功能障碍影响因素分析[J]. 中国卒中杂志,2017(9). DOI:10.3969/j.issn.1673-5765.2017.09.012.

[41] Kramer SF, Hung SH, Brodtmann A. The impact of physical activity before and after stroke on stroke risk and recovery: a narrative review [J]. Curr Neurol Neurosci Rep, 2019, 19(6): 28. DOI: 10.1007/s11910-019-0949-4.

[42] 阮婕,斯晓莉,李凌菲,等. 急性轻型缺血性脑卒中患者卒中后抑郁与血管性认知障碍相关性研究[J]. 浙江医学,2020(21). DOI:10.12056/j.issn.1006-2785.2020.42. 21.2020-769.

[43] 李冠潼,王族,杨国涵,等. 卒中后脑功能的状态调查及相关性分析[J/CD]. 中华脑血管病杂志(电子版),2020, 14(3). DOI:10.11817/j.issn.1673-9248.2020.03.005.

[44] 谢彦彤.脑卒中后焦虑、抑郁状态与注意力、执行功能的相关性研究[D].广州: 南方医科大学, 2020.

[45] 史宇,杨冬冬,黄国志,等.卒中后抑郁发病机制及相关影响因素[J].实用医学杂志,2016,32(6):867-869. DOI:10.3969/j.issn.1006-5725.2016.06.001.