Table 4 Factors affecting cognitive change from 3Â months to 12Â months in older patients
Parameters | Normal Cognition (n = 835) | Declined Cognition (n = 596) | ||||||
|---|---|---|---|---|---|---|---|---|
|  | Stable (n = 612) | Converter (n = 79) | Reverter (n = 144) | P value | Stable (n = 336) | Converter (n = 183) | Reverter (n = 77) | P value |
1) Baseline medical record assessments | ||||||||
Male, n (%) | 375 (61.3) | 37 (46.8) | 66 (45.8) | .000** | 163 (48.5) | 91 (49.7) | 38 (49.4) | .963 |
Age, (mean ± SD) | 73.15 ± 5.86 a | 75.24 ± 6.84 b | 76.53 ± 6.21 b | .000** | 76.06 ± 6.15 | 74.78 ± 5.55 | 75.95 ± 6.09 | .059 |
Education, n (%) | ||||||||
 Uneducated | 98 (16.0) | 24 (30.4) | 41 (28.5) | .000** | 33 (9.8) | 10 (5.5) | 12 (15.6) | .307 |
 0–3 years | 34 (5.6) | 9 (11.4) | 10 (6.9) |  | 36 (10.7) | 20 (10.9) | 9 (11.7) |  |
 4–6 years | 132 (21.6) | 22 (27.8) | 43 (29.9) |  | 106 (31.5) | 61 (33.3) | 23 (29.9) |  |
 7 - 9 years | 103 (16.8) | 12 (15.2) | 25 (17.4) |  | 74 (22.0) | 35 (19.1) | 17 (22.1) |  |
 10 - 12 years | 142 (23.2) | 4 (5.1) | 15 (10.4) |  | 71 (21.1) | 41 (22.4) | 13 (16.9) |  |
 13 years - | 103 (16.8) | 8 (10.1) | 10 (6.9) |  | 16 (4.8) | 16 (8.7) | 3 (3.9) |  |
BMI (kg/m2), (mean ± SD) | 23.72 ± 3.20 | 23.59 ± 3.61 | 23.11 ± 3.43 | .115 | 23.00 ± 2.96 | 23.24 ± 3.15 | 22.26 ± 3.23 | .066 |
Risk factors of stroke, n (%) | ||||||||
 Hypertension | 414 (67.6) | 54 (68.4) | 91 (63.2) | .570 | 212 (63.1) | 116 (63.4) | 55 (71.4) | .371 |
 Diabetes Mellitus | 102 (16.7) | 12 (15.2) | 15 (10.4) | .175 | 55 (16.4) | 28 (15.3) | 17 (22.1) | .392 |
 Coronary heart disease | 60 (9.8) | 8 (10.1) | 11 (7.6) | .711 | 27 (8.0) | 16 (8.7) | 5 (6.5) | .831 |
 Atrial fibrillation | 78 (12.7) | 11 (13.9) | 22 (15.3) | .712 | 59 (17.6) | 27 (14.8) | 10 (13.0) | .515 |
 Hyperlipidemia | 110 (18.0) | 11 (13.9) | 31 (21.5) | .357 | 39 (11.6) | 19 (10.4) | 12 (15.6) | .489 |
 Obesity | 79 (12.9) | 12 (15.2) | 11 (7.6) | .154 | 29 (8.6) | 20 (10.9) | 3 (3.9) | .185 |
 Family history | 52 (8.5) | 4 (5.1) | 11 (7.6) | .562 | 30 (8.9) | 12 (6.6) | 6 (7.8) | .635 |
Smoking, n (%) | ||||||||
 Current smokers | 105 (17.2) | 11 (13.9) | 23 (16.0) | .050 | 67 (19.9) | 27 (14.8) | 19 (24.7) | .285 |
 Former smokers | 107 (17.4) | 10 (12.7) | 12 (8.3) |  | 39 (11.6) | 28 (15.3) | 8 (10.4) |  |
 Never smokers | 400 (65.4) | 58 (73.4) | 109 (75.7) |  | 230 (68.5) | 128 (69.9) | 50 (64.9) |  |
Alcohol consumption, n (%) | ||||||||
 None | 414 (67.6) | 54 (68.4) | 108 (75.0) | .322 | 249 (74.1) | 133 (72.7) | 56 (72.7) | .367 |
 Moderate | 141 (23.0) | 20 (25.3) | 23 (16.0) |  | 63 (18.8) | 28 (15.3) | 15 (19.5) |  |
 Heavy | 57 (9.3) | 5 (6.3) | 13 (9.0) |  | 24 (7.1) | 22 (12.0) | 6 (7.8) |  |
2) Stroke characteristics | ||||||||
Ischemic type (TOAST) | ||||||||
 Large-artery atherosclerosis | 278 (45.4) | 51 (64.6) | 67 (46.5) | .052 | 167 (49.7) | 94 (51.4) | 46 (59.7) | .662 |
 Small-artery occlusion | 155 (25.3) | 11 (13.9) | 39 (27.1) |  | 60 (17.9) | 34 (18.6) | 12 (15.6) |  |
 Cardioembolism | 89 (14.5) | 5 (6.3) | 17 (11.8) |  | 59 (17.6) | 28 (15.3) | 7 (9.1) |  |
 Other determined | 36 (5.9) | 4 (5.1) | 5 (3.5) |  | 15 (4.5) | 5 (2.7) | 4 (5.2) |  |
 Undetermined ischemic stroke | 54 (8.8) | 8 (10.1) | 16 (11.1) |  | 35 (10.4) | 22 (12.0) | 8 (10.4) |  |
Ischemic location | ||||||||
 Rt. hemisphere | 309 (50.5) | 39 (49.4) | 64 (44.4) | .394 | 135 (40.2) | 68 (37.2) | 33 (42.9) | .667 |
 Lt. hemisphere | 247 (40.4) | 31 (39.2) | 70 (48.6) |  | 178 (53.0) | 106 (57.9) | 38 (49.4) |  |
 Both hemisphere | 56 (9.2) | 9 (11.4) | 10 (6.9) |  | 23 (6.8) | 9 (4.9) | 6 (7.8) |  |
Affected level | ||||||||
 Cortical level | 203 (33.2) | 32 (40.5) | 49 (34.0) | .047* | 143 (42.6) | 75 (41.0) | 32 (41.6) | .729 |
 Subcortical level | 193 (31.5) | 20 (25.3) | 30 (20.8) |  | 83 (24.7) | 53 (29.0) | 21 (27.3) |  |
 Brainstem level | 125 (20.4) | 11 (13.9) | 40 (27.8) |  | 42 (12.5) | 20 (10.9) | 13 (16.9) |  |
 Multiple level | 91 (14.9) | 16 (20.3) | 25 (17.4) |  | 68 (20.2) | 35 (19.1) | 11 (14.3) |  |
3) Treatment characteristics | ||||||||
IV thrombolysis | 40 (6.5) | 5 (6.3) | 9 (6.3) | .991 | 27 (8.0) | 16 (8.7) | 7 (9.1) | .935 |
IA thrombolysis | 9 (1.5) | 2 (2.5) | 3 (2.1) | .722 | 20 (6.0) | 4 (2.2) | 1 (1.3) | .049* |
IV heparin | 52 (8.5) | 5 (6.3) | 9 (6.3) | .575 | 29 (8.6) | 10 (5.5) | 8 (10.4) | .301 |
Antiplatelet agent | 485 (79.2) | 65 (82.3) | 115 (79.9) | .818 | 239 (71.1) | 131 (71.6) | 53 (68.8) | .901 |
Rehabilitation Therapy | 157 (25.7) | 25 (31.6) | 43 (29.9) | .363 | 133 (39.6) | 54 (29.5) | 36 (46.8) | .015* |
Cognitive Therapy | 26 (4.2) | 4 (5.1) | 5 (3.5) | .844 | 19 (5.7) | 11 (6.0) | 10 (13.0) | .061 |
4) Neuropsychological assessments | ||||||||
Cognitive function (K-MMSE) | ||||||||
 3 months from onset | 26.86 ± 3.41 a | 23.18 ± 3.69 b | 25.85 ± 3.82 c | .000** | 14.46 ± 9.71 | 15.95 ± 7.64 | 16.08 ± 7.09 | .112 |
 12 months from onset | 26.88 ± 3.50 a | 27.01 ± 3.30 a | 20.66 ± 4.90 b | .000** | 14.68 ± 9.95 a | 22.46 ± 5.78 b | 10.52 ± 7.21 c | .000** |
 Variation (from 3 months to 12 months) | 0.03 ± 1.17 a | 3.84 ± 1.31 b | −5.19 ± 3.05 c | .000** | 0.21 ± 1.10 a | 6.51 ± 4.03 b | −5.56 ± 2.99 c | .000** |
Stroke Severity, ADL, Motor, Gait, Depression, QoL (3Â months from onset) | ||||||||
 NIHSS | 0.78 ± 1.98 a | 1.15 ± 2.06 a | 1.32 ± 2.15 b | .009** | 5.75 ± 7.43 a | 3.17 ± 4.69 b | 5.08 ± 4.68 b | .000** |
 mRS | 1.12 ± 1.12 a | 1.51 ± 1.32 b | 1.63 ± 1.25 b | .000** | 2.79 ± 1.68 a | 2.37 ± 1.54 b | 3.26 ± 1.29 a | .000** |
 FIM | 117.40 ± 15.58 a | 113.08 ± 18.30 ab | 111.16 ± 19.83 b | .000** | 83.68 ± 39.78 a | 95.74 ± 32.33 b | 81.34 ± 31.60 a | .001** |
 K-MBI | 93.31 ± 16.11 a | 89.09 ± 17.82 ab | 87.34 ± 19.10 b | .000** | 64.13 ± 38.83 a | 75.71 ± 30.51 b | 61.61 ± 32.50 a | .001** |
 FMA (affected side) | 93.92 ± 16.11 | 90.53 ± 19.31 | 91.44 ± 17.83 | .094 | 70.49 ± 36.80 a | 81.45 ± 30.54 b | 65.90 ± 35.97 a | .000** |
 FAC | 4.51 ± 1.05 a | 4.15 ± 1.40 b | 4.00 ± 1.35 b | .000** | 2.83 ± 2.10 a | 3.45 ± 1.79 b | 2.70 ± 1.87 a | .001** |
 GDS | 5.40 ± 3.79 a | 6.83 ± 4.19 b | 7.41 ± 4.35 b | .000** | 7.63 ± 4.09 a | 8.03 ± 4.27 ab | 9.65 ± 4.04 b | .022* |
 EQ-5D | 0.76 ± 0.29 a | 0.67 ± 0.34 b | 0.63 ± 0.36 b | .000** | 0.39 ± 0.41 a | 0.49 ± 0.40 b | 0.31 ± 0.37 a | .003** |