RELATIONSHIP BETWEEN LEVEL OF EDUCATION AND POST-STROKE COGNITIVE STATUS IN HOSPITAL-BASED ISCHEMIC STROKE SURVIVORS

Herpan Syafii Harahap, Yanna Indrayana, Setyawati Asih Putri
  MNJ, pp. 1-6  

Abstract


Background: Post-ischemic stroke cognitive decline is significantly affecting the quality of life of its survivors. Its prevalence was about 7.5-72% which was mostly determined by the existing of vascular risk factors and cognitive reserve of the subjects. Level of education is one of determinants of cognitive reserve, a factor that affect the susceptibility of subjects to cognitive decline after experiencing ischemic stroke-related neuronal damage. Since level of education is protective for cognitive function, the intervention on it can reduce the occurrence of cognitive decline.

Objective: To investigate the relationship between level of education and cognitive status among hospital-based ischemic stroke survivors.

Methods: This cross-sectional study involved post-ischemic stroke outpatients in two hospitals. The data collected in this study were demographic data, including level of education, and clinical data as well. The level of education was categorized into ≥12 years and <12 years groups. Cognitive status was assessed using Montreal Cognitive Assessment in Indonesia version (MoCA-Ina) and subjects with score of 26-30 were normal. The relationship between level of education as well as clinical data and cognitive status were analyzed using chi-square test.

Results: There were 166 subjects eligible for this study (n=166). The mean age of subjects was 58 years and 68.67% of them were male. Cognitive decline were found 80.12% of subjects (n=133). The level of education was significantly associated with cognitive status of the subjects and hypertension as well.

Conclusion: The level of education had significant relationship with cognitive decline in the hospital-based population of ischemic stroke survivors.


Keywords


Post-ischemic stroke cognitive decline, level of education, cognitive reserve

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References


Melkas S, Jokinen H, Hietanen M, Erkinjuntti T. Poststroke cognitive impairment and dementia :

prevalence, diagnosis, and treatment. Degener Neurol Neuromuscul Dis; 2014. 4:21–7.

DOI: http://dx.doi.org/10.2147/DNND.S37353.

Zulkifly MFM, Ghazali SE, Din NC, Singh DKA, Subramaniam P. A Review of Risk Factors for Cognitive Impairment in Stroke Survivors. Sci World J; 2016. 2016:3456943.

DOI: http://dx.doi.org/10.1155/2016/3456943.

Sun J-H, Tan L, Yu J-T. Post-stroke cognitive impairment: epidemiology, mechanisms, and management. Ann Transl Med; 2014. 2(8):80.

DOI: 10.3978/j.issn.2305-5839.2014.08.05.

Steffener J, Stern Y. Exploring the neural basis of cognitive reserve in aging. Biochim Biophys Acta; 2012. 1822(3):467–73.

DOI: http://dx.doi.org/10.1016/j.bbadis.2011.09.012

Darwish H, Farran N, Assaad S, Chaaya M. Cognitive reserve factors in a developing country : Education and occupational attainment lower the risk of dementia in a sample of lebanese older adults. Front Aging Neurosci; 2018. 10:277.

DOI: 10.3389/fnagi.2018.00277.

Agoes A, Lestari R, Alfaruqi S. Effects of brain age to increase cognitive function in elderly. MNJ; 2016. 2(2):64–70.

DOI: 10.21776/ub.mnj.2016.002.02.4

Gorelick PB, Scuteri A, Black SE, DeCarli C, Greenberg SM, Iadecola C, et al. Vascular Contributions to Cognitive Impairment and Dementia: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke; 2011. 42(9):2672–713.

DOI: 10.1161/STR.0b013e3182299496.

Faizal M, Zulkifly M, Ghazali SE, Din NC, Kaur D, Singh A, et al. A Review of Risk Factors for Cognitive Impairment in Stroke Survivors. Sci World J; 2016. 2016:3456943.

DOI: http://dx.doi.org/10.1155/2016/3456943

Munir B, Al Rasyid H, Rosita R. Relationship between The Random Blood Glucose Levels During Admission at Emergency Room with Clinical Output in Acute Ischemic Stroke Patients. MNJ; 2015. 1(2):52–60.

DOI: 10.21776/ub.mnj.2015.001.02.2

Levine DA, Wadley VG, Langa KM, Howard G, Howard VJ, Cushman M. Risk factors for post-stroke cognitive decline: The REGARDS study. Stroke; 2018. 49(4):987–94.

DOI: 10.1161/STROKEAHA.117.018529

Jackson-Koku G. Beck depression inventory. Occup Med (Chic Ill); 2016. 66:174–5.

DOI: 10.1093/occmed/kqv087

Wang Y-P, Gorenstein C. Assessment of depression in medical patients : A systematic review of the utility of the Beck Depression Inventory-II. Clinics; 2013. 68(9):1274–87.

DOI: 10.6061/clinics/2013(09)15

Crowe M, Clay OJ, Martin RC, Howard VJ, Wadley VG, Sawyer P, et al. Indicators of childhood quality of education in relation to cognitive function in older adulthood. J Gerontol A Biol Sci Med Sci; 2013. 68(2):198–204. DOI: 10.1093/gerona/gls122

Aminov A, Rogers JM, Johnstone SJ, Middleton S, Wilson H. Acute single channel EEG predictors of cognitive function after stroke. PLoS One; 2017. 12(10):e0185841.

DOI: http://dx.doi.org/10.1371/journal.pone.0185841

Lestari S, Mistivani I, Rumende C, Kusumaningsih W. Comparison between mini mental state examination (MMSE) and Montreal cognitive assessment Indonesian version (MoCA-Ina) as an early detection of cognitive impairments in post-stroke patients. J Phys Conf Ser; 2017. 884:012153.

DOI: 10.1088/1742-6596/884/1/012153

Mellon L, Brewer L, Hall P, Horgan F, Williams D, Hickey A. Cognitive impairment six months after ischaemic stroke : a profile from the ASPIRE-S study. BMC Neurol; 2015. 2015:31. DOI: 10.1186/s12883-015-0288-2

Barbay M, Diouf M, Roussel M, Godefroy O. Systematic review and meta-analysis of prevalence in post-stroke neurocognitive disorders in hospital-based studies. Dement Geriatr Cogn Disord; 2018. 46:322–34. DOI: 10.1159/000492920

Sexton E, Mcloughlin A, Williams DJ, Merriman NA, Donnelly N, Rohde D, et al. Systematic review and meta-analysis of the prevalence of cognitive impairment no dementia in the first year post-stroke. Eur Stroke J. 2019;4(2):160–71.

DOI: 10.1177/2396987318825484

Nurani RRS, Martini S. Risk factors for cognitive impairment after ischemic stroke. KnE Life Sci; 2018. 2018:87–96. DOI: 10.18502/kls.v4i9.3560

Ihle-Hansen H, Thommessen B, Fagerland MW, Øksengård AR, Wyller TB, Engedal K, et al. Multifactorial vascular risk factor intervention to prevent cognitive impairment after stroke and TIA : A 12-month randomized controlled trial. Int J Stroke; 2014. 9:932–8. DOI: 10.1111/j.1747-4949.2012.00928.x

Surawan J, Areemit S, Tiamkao S, Sirithanawuthichai T, Saensak S. Risk factors associated with post-stroke dementia : a systematic review and meta-analysis. Neurol Int; 2017. 9:7216.

DOI: 10.4081/nir.2017.7216.

Mijajlovic MD, Pavlovic A, Brainin M, Heiss W, Quinn TJ, Ihle-hansen HB, et al. Post-stroke dementia: A comprehensive review. BMC Med; 2017. 15(1):11. DOI: 10.1186/s12916-017-0779-7

Peters R, Booth A, Rockwood K, Peters J, Este CD, Anstey KJ. Combining modifiable risk factors and risk of dementia : a systematic review and meta-analysis. BMJ Open; 2019. 9:E022846. DOI:10.1136/bmjopen-2018-022846

Kalaria RN, Akinyemi R, Ihara M. Stroke injury , cognitive impairment and vascular dementia. BBA - Mol Basis Dis; 2016. 1862(5):915–25.

DOI: http://dx.doi.org/10.1016/j.bbadis.2016.01.015

Sharp SI, Aarsland D, Day S, Sønnesyn H. Hypertension is a potential risk factor for vascular dementia : Systematic review. Int J Geriatr Psychiatry; 2011. 26:661–9. DOI: 10.1002/gps.2572

Tadic M, Cuspidi C, Hering D. Hypertension and cognitive dysfunction in elderly: blood pressure management for this global burden. BMC Cardiovasc Disord; 2016. 16:208.

DOI: http://dx.doi.org/10.1186/s12872-016-0386-0

Dariusz G, Kwarciany M, Nyka W, Narkiewicz K. Hypertension, Brain Damage and Cognitive Decline. Curr Hypertens Rep; 2013. 15:547–58.

DOI 10.1007/s11906-013-0398-4

Sörös P, Whitehead S, Spence JD, Hachinski V. Antihypertensive treatment can prevent stroke and cognitive decline. Nat Rev Neurol; 2013. 9(3):174–8. DOI: 10.1038/nrneurol.2012.255

Stern Y. Cognitive Reserve: Implications for assessment and intervention. Folia Phoniatr Logop; 2013. 65(2):49–54. DOI: 10.1159/000353443

Umarova RM. Adapting the concepts of brain and cognitive reserve to post-stroke cognitive deficits : Implications for understanding neglect. Cortex; 2017. 97:327–38.

DOI: http://dx.doi.org/10.1016/j.cortex.2016.12.006

Barulli D, Stern Y.d Efficiency, capacity, compensation, maintenance, plasticity: emerging concepts in cognitive reserve. Trends Cogn Sci; 2013. 17(10):502–9. DOI: 10.1016/j.tics.2013.08.012

Wang Y, Du Y, Li J, Qiu C. Lifespan intellectual factors, genetic susceptibility, and cognitive phenotypes in aging : Implications for interventions. Front Aging Neurosci; 2019. 11:129.

DOI: 10.3389/fnagi.2019.00129

Jung N-Y, Cho H, Kim YJ, Kim HJ, Lee JM, Park S, et al. The impact of education on cortical thickness in amyloid-negative subcortical vascular dementia : cognitive reserve hypothesis. Alzheimer’s Res Ther; 2018. 10:103. DOI: 10.1186/s13195-018-0432-5

Farfel JM, Nitrini R, Suemoto CK, Grinberg LT, Lucena RE, Paraizo RE, et al. Very low levels of education and cognitive reserve: A clinicopathologic study. Neurology; 2013. 81:650–7.

DOI: 10.1212/WNL.0b013e3182a08f1b

Mirza SS, Portegies MLP, Wolters FJ, Hofman A, Koudstaal PJ, Tiemeier H, et al. Higher education is associated with a lower risk of dementia after a stroke or TIA . The Rotterdam Study. Neuroepidemiology; 2016. 46:120–7. DOI: 10.1159/000443649


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