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Post-Stroke Cognitive Disorders and Associated Factors in French Speaking West Africa, Benin Case

Post-Stroke Cognitive Disorders and Associated Factors in French Speaking West Africa, Benin Case

作     者:Dieu Donné Gnonlonfoun Paul Macaire Ossou-Nguiet Lansana Laho Diallo Constant Adjien Isaac Avlessi Gérard Goudjinou Octave Houannou Dismand Houinato Gilbert Dossou Avode 

作者机构:Neurology Department Centre Hospitalier et Universitaire de Conakry Conakry Guinée Neurology Department Centre Hospitalier et Universitaire of Brazzaville Brazzaville Congo Neurology Department Centre National Hospitalier et Un-iversitaire Hubert Koutoukou MAGA de Cotonou (CNHU-HKM) Cotonou Benin 

出 版 物:《Neuroscience & Medicine》 (神经系统科学与医药(英文))

年 卷 期:2014年第5卷第1期

页      面:32-41页

学科分类:1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主  题:Stroke Cognitive Decline Dementia Benin 

摘      要:Introduction: Cognitive disorders frequency arising after a cardio-cerebral vascular disease (stroke) is currently on the rise due to the ageing population and the increase in the number of survivors after stroke occurrence. Objective: Determining post-stroke cognitive decline and identifying associated factors. Method: It consists in a cross-sectional, prospective, descriptive and analytical study which was conducted from April 1 to August 31, 2013 in the Neurology Department of CNHU-HKM in Cotonou. The study involved 100 patients who have known stroke for at least the past 6 months and were all admitted and discharged later on. The disease survivors were re-contacted and examined again at home or at hospital. The cognitive decline (CD) was estimated by using a modified and adapted MMSE to suit our cultural era. Results: All patients were aged 58.9 years ± 13.6 years. Sex-ratio was 1.4. Cognitive decline frequency was 20%. Post-stroke cognitive decline frequency per sex was 11.6% and 8.4% respectively for females and males. Ischemia stroke patients had a higher cognitive decline (22.5%). 58.3% had severe CD. Moreover the CD frequency increased with time, from 16.7% in a year to 50% in 3 years. Total MMSE varied from 6 to 23 with 21 as median. From the unvaried analysis, the presence of sphincter disorders (1.26 [0.35-4.59], p = 0.004), consciousness disorders (15.67 [1.46-168], p = 0.04), and convulsion disorders (3.77 [1.01 -14.00], p = 0.003) was associated with cognitive decline. From multi-varied analysis, the sole presence of convulsive attacks (11.5 [1.79-73.58], p = 0.01) was individually associated with post-stroke cognitive decline. Conclusion: This study reveals the importance of CD after stroke. The occurrence of convulsions at stroke acute stage is a prognostic factor of CD medium or long-term occurrence. The overall coverage improvement depends on the integration of these data in stroke reach-out programs.

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