The influence of demographic, clinical, psychological and functional determinants on post-stroke cognitive impairment at day care stroke center, Malaysia

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Abstract

Background: This study aims to estimate the prevalence and explore the predictors for post-stroke cognitive impairment at the community level in Malaysia. Methods: A total of 50 stroke patients aged 29 to 81–year-old were included in this study. A face to face interview was conducted to gather the demographic and clinical data. Subsequently, assessments including Barthel ADL Index (BI), Addenbrooke's Cognitive Examination-Revised (ACE-R) and Hospital Anxiety and Depression Scale (HADS) were administered to the subjects. Results: The results showed that the prevalence of cognitive impairment was 76% among the studied populations. The subjects’ race (Fisher’s value= 9.56, P <0.05) and education level (Fisher’s value = 7.29, P <0.05) were significantly associated with the cognitive status. The depression score was significantly higher in cognitively impaired group [t (48) = –4.42, P <0.001] while the Barthel Index score was significantly lower in cognitively impaired group (median = 18.00, P <0.05). The univariate logistic analysis demonstrated that Chinese (OR 7.33, 95% CI = 1.61–33.51), lower education level (OR 9.33, 95% CI = 0.89–97.62), right sided lesion (OR 0.29, 95% CI = 0.06–1.54), left face weaknesses (OR 0.40, 95% CI 0.09–1.83), high cholesterol (OR 0.45, 95% CI = 0.12–1.75), depression (OR 2.16, 95% CI = 0.85–1.35), and Barthel Index (OR 0.79, 95% CI = 0.57–1.10) were significant predictors. Finally, multivariate logistic regression verified that depression was the only significant predictor of post-stroke cognitive impairment (OR 2.03, 95% CI = 1.20–3.45). Conclusion: In conclusion, the prevalence of cognitive impairment in this study was higher than other community based studies and depression was a risk factor for cognitive impairment.

Original languageEnglish
Pages (from-to)53-64
Number of pages12
JournalMalaysian Journal of Medical Sciences
Volume23
Issue number2
Publication statusPublished - 1 Mar 2016

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Malaysia
Stroke
Demography
Depression
Psychology
Education
Activities of Daily Living
Anxiety
Logistic Models
Cholesterol
Cognitive Dysfunction
Interviews
Population

Keywords

  • Cerebrovascular disorders
  • Depression
  • Mild cognitive impairment
  • Risk factors
  • Stroke

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{c676c0cdd1b5403d8f977ed29f5e7cb1,
title = "The influence of demographic, clinical, psychological and functional determinants on post-stroke cognitive impairment at day care stroke center, Malaysia",
abstract = "Background: This study aims to estimate the prevalence and explore the predictors for post-stroke cognitive impairment at the community level in Malaysia. Methods: A total of 50 stroke patients aged 29 to 81–year-old were included in this study. A face to face interview was conducted to gather the demographic and clinical data. Subsequently, assessments including Barthel ADL Index (BI), Addenbrooke's Cognitive Examination-Revised (ACE-R) and Hospital Anxiety and Depression Scale (HADS) were administered to the subjects. Results: The results showed that the prevalence of cognitive impairment was 76{\%} among the studied populations. The subjects’ race (Fisher’s value= 9.56, P <0.05) and education level (Fisher’s value = 7.29, P <0.05) were significantly associated with the cognitive status. The depression score was significantly higher in cognitively impaired group [t (48) = –4.42, P <0.001] while the Barthel Index score was significantly lower in cognitively impaired group (median = 18.00, P <0.05). The univariate logistic analysis demonstrated that Chinese (OR 7.33, 95{\%} CI = 1.61–33.51), lower education level (OR 9.33, 95{\%} CI = 0.89–97.62), right sided lesion (OR 0.29, 95{\%} CI = 0.06–1.54), left face weaknesses (OR 0.40, 95{\%} CI 0.09–1.83), high cholesterol (OR 0.45, 95{\%} CI = 0.12–1.75), depression (OR 2.16, 95{\%} CI = 0.85–1.35), and Barthel Index (OR 0.79, 95{\%} CI = 0.57–1.10) were significant predictors. Finally, multivariate logistic regression verified that depression was the only significant predictor of post-stroke cognitive impairment (OR 2.03, 95{\%} CI = 1.20–3.45). Conclusion: In conclusion, the prevalence of cognitive impairment in this study was higher than other community based studies and depression was a risk factor for cognitive impairment.",
keywords = "Cerebrovascular disorders, Depression, Mild cognitive impairment, Risk factors, Stroke",
author = "{Mohd Zulkifly}, {Mohd Faizal} and Ghazali, {Shazli Ezzat} and {Che Din}, Normah and Ponnusamy Subramaniam",
year = "2016",
month = "3",
day = "1",
language = "English",
volume = "23",
pages = "53--64",
journal = "Malaysian Journal of Medical Sciences",
issn = "1394-195X",
publisher = "Universiti Sains Malaysia",
number = "2",

}

TY - JOUR

T1 - The influence of demographic, clinical, psychological and functional determinants on post-stroke cognitive impairment at day care stroke center, Malaysia

AU - Mohd Zulkifly, Mohd Faizal

AU - Ghazali, Shazli Ezzat

AU - Che Din, Normah

AU - Subramaniam, Ponnusamy

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Background: This study aims to estimate the prevalence and explore the predictors for post-stroke cognitive impairment at the community level in Malaysia. Methods: A total of 50 stroke patients aged 29 to 81–year-old were included in this study. A face to face interview was conducted to gather the demographic and clinical data. Subsequently, assessments including Barthel ADL Index (BI), Addenbrooke's Cognitive Examination-Revised (ACE-R) and Hospital Anxiety and Depression Scale (HADS) were administered to the subjects. Results: The results showed that the prevalence of cognitive impairment was 76% among the studied populations. The subjects’ race (Fisher’s value= 9.56, P <0.05) and education level (Fisher’s value = 7.29, P <0.05) were significantly associated with the cognitive status. The depression score was significantly higher in cognitively impaired group [t (48) = –4.42, P <0.001] while the Barthel Index score was significantly lower in cognitively impaired group (median = 18.00, P <0.05). The univariate logistic analysis demonstrated that Chinese (OR 7.33, 95% CI = 1.61–33.51), lower education level (OR 9.33, 95% CI = 0.89–97.62), right sided lesion (OR 0.29, 95% CI = 0.06–1.54), left face weaknesses (OR 0.40, 95% CI 0.09–1.83), high cholesterol (OR 0.45, 95% CI = 0.12–1.75), depression (OR 2.16, 95% CI = 0.85–1.35), and Barthel Index (OR 0.79, 95% CI = 0.57–1.10) were significant predictors. Finally, multivariate logistic regression verified that depression was the only significant predictor of post-stroke cognitive impairment (OR 2.03, 95% CI = 1.20–3.45). Conclusion: In conclusion, the prevalence of cognitive impairment in this study was higher than other community based studies and depression was a risk factor for cognitive impairment.

AB - Background: This study aims to estimate the prevalence and explore the predictors for post-stroke cognitive impairment at the community level in Malaysia. Methods: A total of 50 stroke patients aged 29 to 81–year-old were included in this study. A face to face interview was conducted to gather the demographic and clinical data. Subsequently, assessments including Barthel ADL Index (BI), Addenbrooke's Cognitive Examination-Revised (ACE-R) and Hospital Anxiety and Depression Scale (HADS) were administered to the subjects. Results: The results showed that the prevalence of cognitive impairment was 76% among the studied populations. The subjects’ race (Fisher’s value= 9.56, P <0.05) and education level (Fisher’s value = 7.29, P <0.05) were significantly associated with the cognitive status. The depression score was significantly higher in cognitively impaired group [t (48) = –4.42, P <0.001] while the Barthel Index score was significantly lower in cognitively impaired group (median = 18.00, P <0.05). The univariate logistic analysis demonstrated that Chinese (OR 7.33, 95% CI = 1.61–33.51), lower education level (OR 9.33, 95% CI = 0.89–97.62), right sided lesion (OR 0.29, 95% CI = 0.06–1.54), left face weaknesses (OR 0.40, 95% CI 0.09–1.83), high cholesterol (OR 0.45, 95% CI = 0.12–1.75), depression (OR 2.16, 95% CI = 0.85–1.35), and Barthel Index (OR 0.79, 95% CI = 0.57–1.10) were significant predictors. Finally, multivariate logistic regression verified that depression was the only significant predictor of post-stroke cognitive impairment (OR 2.03, 95% CI = 1.20–3.45). Conclusion: In conclusion, the prevalence of cognitive impairment in this study was higher than other community based studies and depression was a risk factor for cognitive impairment.

KW - Cerebrovascular disorders

KW - Depression

KW - Mild cognitive impairment

KW - Risk factors

KW - Stroke

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JO - Malaysian Journal of Medical Sciences

JF - Malaysian Journal of Medical Sciences

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