Gait Measures as Predictors of Poststroke Cognitive Function Evidence From the TABASCO Study

被引:24
|
作者
Ben Assayag, Einor [1 ,2 ,3 ]
Shenhar-Tsarfaty, Shani [1 ,2 ]
Korczyn, Amos D. [3 ]
Kliper, Efrat [1 ,2 ,3 ]
Hallevi, Hen [1 ,2 ,3 ]
Shopin, Ludmila [1 ,2 ]
Auriel, Eitan [1 ,2 ,3 ]
Giladi, Nir [1 ,2 ,3 ]
Mike, Anat [1 ,2 ]
Halevy, Anat [1 ,2 ]
Weiss, Aner [1 ,2 ]
Mirelman, Anat [1 ,2 ]
Bornstein, Natan M. [1 ,2 ,3 ]
Hausdorff, Jeffrey M. [3 ]
机构
[1] Dana Childrens Hosp, Tel Aviv Med Ctr, Dept Neurol, Stroke Unit, IL-64239 Tel Aviv, Israel
[2] Dana Childrens Hosp, Tel Aviv Med Ctr, Ctr Study Movement Cognit & Mobil, Dept Neurol, IL-64239 Tel Aviv, Israel
[3] Tel Aviv Univ, Sackler Fac Med, IL-69978 Tel Aviv, Israel
关键词
gait; mild cognitive impairment; stroke; ELDERLY PERSONS; GO TEST; IMPAIRMENT; STROKE; DEMENTIA; DECLINE; SPEED; ASSOCIATION; MOBILITY; BALANCE;
D O I
10.1161/STROKEAHA.114.007346
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose-Patients with stroke are at risk for developing cognitive impairment. We tested whether the assessment of balance and gait can enhance the prediction of long-term cognitive outcome in stroke survivors. Methods-Participants were patients with first-ever, mild-moderate ischemic stroke or transient ischemic attack from the Tel Aviv Brain Acute Stroke Cohort (TABASCO) study, a large prospective cohort study, who underwent 3-T MRI and were followed for >= 2 years using neurological, neuropsychological, and mobility examinations 6, 12, and 24 months after the index event. Results-Data were available for 298 patients (age: 66.7 +/- 9.6 years). Forty-six participants (15.4%) developed cognitive decline (CD) over the 2 years of follow-up. The CD group and cognitively intact group did not differ in their neurological deficits or in their infarct volume or location. Nonetheless, 6 months after stroke, the Timed Up and Go test took longer in those who later developed CD (P<0.001). Additionally, the CD group also had lower Berg Balance Scale scores (P<0.001), slower gait (P<0.001), and fewer correct answers during dual-task walking (P=0.006). Separate analyses of the patients with transient ischemic attack revealed similar results. Multivariate regression analysis showed that Timed Up and Go times >12 s at 6 months after stroke/transient ischemic attack was a significant independent risk marker of CD 24 months after stroke (odds ratio=6.07, 95% confidence interval: 1.36-27.15). Conclusions-These results suggest that measures of balance and gait are significant risk markers of cognitive status 2 years after stroke. Relatively simple, performance-based tests of mobility may enhance the identification of stroke/transient ischemic attack survivors who have an increased risk of developing CD.
引用
收藏
页码:1077 / +
页数:13
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