关于撒哈拉以南非洲(SSA)新发卒中后痴呆(NPSD)的信息有限。我们估计了发病率,累积发病率,尼日利亚首次卒中幸存者1年NPSD的危险因素和结局.
基于医院的前瞻性观察研究。全球认知评估,学习,记忆,在卒中后3个时间点进行执行和日常生活活动(ADL)功能(基线,3-和12个月)。NPSD是根据国家神经疾病和中风研究所和国际神经科学协会(NINDS-AIREN)标准确定的。“使用改良的Rankin量表(mRS)评估结果,流行病学研究中心抑郁量表(CES-D10),卒中患者健康相关生活质量(HRQOLISP-26)和照顾者应变指数(CSI)。
在144名中风幸存者中,他们在基线时没有痴呆,我们发现1年累积发病率为4.52%(95%C.I=3.20,6.39).在多变量Cox回归分析中,糖尿病与NPSD相关(危险比=2.10,95%CI=1.02,4.35).3个月时的NPSD与运动衰退独立相关[mRS的平均差(MD)=1.6,95%C.I=0.9,2.3],抑郁症(CES-D中的MD=2.9,95%C.I=0.3,5.4),护理人员负担(CSI中的MD=1.2,95%C.I=0.5,1.8),1年时生活质量差(HRQOLISP-26中的MD=-11.2,95%C.I=-15.7,-6.8)。
尼日利亚约4.5%的卒中幸存者在1年时患有NPSD。糖尿病,这是可以预防的,代表NPSD的一级预防目标及其在SSA中的后果。
There is limited information on new onset poststroke dementia (NPSD) in sub-Saharan Africa (SSA). We estimated incidence, cumulative incidence, risk factors and outcome of NPSD at 1 year in Nigerian survivors of a first-ever stroke.
Hospital-based prospective observational study. Assessments for global cognition, learning, memory, executive and activities of daily life (ADL) functioning were conducted at 3 poststroke timepoints (Baseline, 3- and 12 months). NPSD was ascertained according to the \"National Institute of Neurological Disorders and Stroke and the Association Internationale pour la Recherche et l\'Enseignement en Neurosciences (NINDS-AIREN) criteria.\" Outcomes were assessed using the modified Rankin Scale (mRS), center for epidemiologic studies depression scale (CES-D 10), health related quality of life in stroke patients (HRQOLISP-26) and caregivers strain index (CSI).
Among 144 stroke survivors who were free of dementia at baseline, we found a 1-year cumulative incidence of 4.52% (95% C.I = 3.20, 6.39). In multivariate Cox regression analyses, diabetes was associated with NPSD (Hazard Ratio = 2.10, 95% CI = 1.02, 4.35). NPSD at 3 months was independently associated with motor decline [Mean difference (MD) in mRS = 1.6, 95% C.I = 0.9, 2.3)], depression (MD in CES-D = 2.9, 95% C.I = 0.3, 5.4), caregivers burden (MD in CSI = 1.2, 95% C.I = 0.5, 1.8), and poor quality of life (MD in HRQOLISP-26 = -11.2, 95% C.I = -15.7, -6.8) at 1 year.
Approximately 4.5% of stroke survivors in Nigeria had NPSD at 1 year. Diabetes, which can be prevented, represent a primary prevention target for NPSD and its consequences in SSA.