Subacute cognitive impairment after first-ever transient ischemic attack or ischemic stroke in young adults: the ODYSSEY study

Schellekens, M.M.I.; Boot, E.M.; Verhoeven, J.I.; Ekker, M.S.; Alebeek, M.E. van; Brouwers, P.J.A.M.; Arntz, R.M.; Dijk, G.W. van; Gons, R.A.R.; Uden, I.W.M. van; Heijer, T. den; Kort, P.L.M. de; Laat, K.F. de; Norden, A. van; Vermeer, S.E.; Zagten, M.S.G. van; Oostenbrugge, R.J. van; Wermer, M.J.; Nederkoorn, P.J.; Rooij, F.G. van; Wijngaard, I.R. van den; Leeuw, F.E. de; Kessels, R.P.C.; Tuladhar, A.M.

doi:doi:10.1177/23969873221132032

Introduction:We aimed to investigate the prevalence of cognitive impairment in the subacute phase after transient ischemic attack (TIA) and ischemic stroke (IS), factors associated with a vascular cognitive disorder, and the prevalence of subjective cognitive complaints and their relation with objective cognitive performance.Patients and methods:In this multicenter prospective cohort study, we recruited patients with first-ever TIA and IS, aged 18–49 years, between 2013 and 2021 for cognitive assessment up to 6 months after index event. We calculated composite Z-scores for seven cognitive domains. We defined cognitive impairment as a composite Z-score < −1.5. We defined major vascular cognitive disorder as a Z-score < −2.0 in one or more cognitive domains.Results:Fifty three TIA and 545 IS patients completed cognitive assessment with mean time to assessment of 89.7 (SD 40.7) days. The median NIHSS at admission was 3 ...Show moreIntroduction:We aimed to investigate the prevalence of cognitive impairment in the subacute phase after transient ischemic attack (TIA) and ischemic stroke (IS), factors associated with a vascular cognitive disorder, and the prevalence of subjective cognitive complaints and their relation with objective cognitive performance.Patients and methods:In this multicenter prospective cohort study, we recruited patients with first-ever TIA and IS, aged 18–49 years, between 2013 and 2021 for cognitive assessment up to 6 months after index event. We calculated composite Z-scores for seven cognitive domains. We defined cognitive impairment as a composite Z-score < −1.5. We defined major vascular cognitive disorder as a Z-score < −2.0 in one or more cognitive domains.Results:Fifty three TIA and 545 IS patients completed cognitive assessment with mean time to assessment of 89.7 (SD 40.7) days. The median NIHSS at admission was 3 (interquartile range, 1–5). Cognitive impairment was common in five domains (up to 37%), with similar proportion in TIA and IS patients. Patients with major vascular cognitive disorder had a lower education level, higher NIHSS scores and more frequent lesions in the left frontotemporal lobe than without vascular cognitive disorder (p < 0.05 FDR-corrected). Subjective memory and executive cognitive complaints were present in about two-thirds of the patients, but were weakly associated with objective cognitive performance (β: −0.32 and −0.21, respectively).Discussion and conclusion:In the subacute phase after TIA or stroke in young adults, cognitive impairment and subjective cognitive complaints are prevalent, but they are weakly associated with each other.Show less

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Subacute cognitive impairment after first-ever transient ischemic attack or ischemic stroke in young adults: the ODYSSEY study