Cognitive performance following lacunar stroke in Spanish‐speaking patients: results from the SPS3 trial. Issue 4 (June 2015)

• Record Type: Journal Article
• Authors: Jacova, Claudia; Pearce, Lesly A.; Roldan, Ana M.; Arauz, Antonio; Tapia, Jorge; Costello, Raymond; McClure, Leslie A.; Hart, Robert G.; Benavente, Oscar R.
• Is Part Of: International journal of stroke. Volume 10:Issue 4(2015:Jun.)
• Page Start: 519
• Page End: 528
• Publication Date: 2015-06
• Subjects: 616.8005
• DOI: 10.1111/ijs.12511
• Languages: English
• ISSNs: 1747-4930

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ijs12511-sec-0001" sec-type="section"> <title>Background</title> <p>Cognitive impairment is frequent in lacunar stroke patients. The prevalence and pattern among Spanish‐speaking patients are unknown and have not been compared across regions or with English‐speaking patients.</p> </sec> <sec id="ijs12511-sec-0002" sec-type="section"> <title>Aims</title> <p>The aim of this study was to characterize cognitive impairment in Spanish‐speaking patients and compare it with English‐speaking patients.</p> </sec> <sec id="ijs12511-sec-0003" sec-type="section"> <title>Methods</title> <p>The baseline neuropsychological test performance and the prevalence of mild cognitive impairment, defined as a z‐score ≤ −1·5 on memory and/or non‐memory tests, were evaluated in Spanish‐speaking patients in the Secondary Prevention of Small Subcortical Strokes trial.</p> </sec> <sec id="ijs12511-sec-0004" sec-type="section"> <title>Results</title> <p>Out of 3020 participants, 1177 were Spanish‐speaking patients residing in Latin America (<italic>n</italic> = 693), the United States (<italic>n</italic> = 121), and Spain (<italic>n</italic> = 363). Low education (zero‐ to eight‐years) was frequent in Spanish‐speaking patients (49–57%). Latin American Spanish‐speaking patients had frequent post‐stroke upper extremity motor impairment (83%). Compared with English‐speaking patients, all Spanish‐speaking patient groups had smaller memory deficits and larger non‐memory/motor deficits, with Latin American Spanish‐speaking patients showing the largest deficits median z‐score −1·3 to −0·6 non‐memory tests; ≤5·0 for Grooved Pegboard; −0·7 to −0·3 for memory tests). The prevalence of mild cognitive impairment was high and comparable with English‐speaking patients in the United States and Latin American Spanish‐speaking patients but not the Spanish group: English‐speaking patients = 47%, Latin American Spanish‐speaking patients = 51%, US Spanish‐speaking patients = 40%, Spanish Spanish‐speaking patients = 29%, with >50% characterized as non‐amnestic in Spanish‐speaking patient groups. Older age [odds ratio per 10 years = 1·52, confidence interval = 1·35–1·71), lower education (odds ratio 0–4 years = 1·23, confidence interval = 0·90–1·67), being a Latin American resident (odds ratio = 1·31, confidence interval = 0·87–1·98), and post‐stroke disability (odds ratio Barthel Index <95 = 1·89, confidence interval = 1·43–2·50) were independently associated with mild cognitive impairment.</p> </sec> <sec id="ijs12511-sec-0005" sec-type="section"> <title>Conclusions</title> <p>Mild cognitive impairment in Secondary Prevention of Small Subcortical Strokes Spanish‐speaking patients with recent lacunar stroke is highly prevalent but has a different pattern to that observed in English‐speaking patients. A combination of socio‐demographics, stroke biology, and stroke care may account for these differences.</p> </sec> </abstract>