TITLE:
Post-Stroke Cognitive Disorders and Associated Factors in French Speaking West Africa, Benin Case
AUTHORS:
Dieu Donné Gnonlonfoun, Paul Macaire Ossou-Nguiet, Lansana Laho Diallo, Constant Adjien, Isaac Avlessi, Gérard Goudjinou, Octave Houannou, Dismand Houinato, Gilbert Dossou Avode
KEYWORDS:
Stroke; Cognitive Decline; Dementia; Benin
JOURNAL NAME:
Neuroscience and Medicine,
Vol.5 No.1,
March
7,
2014
ABSTRACT:
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.