Cognitive impairment and disability after arterial stroke in older adults: A hospital‐based study
Bibliographic record
Abstract
Abstract Background Stroke and cognitive impairment often co‐exist in older adults. Every one minute three people get stroke in India, who are potentially at risk for cognitive impairment. However the literature on this area is limited from India.The objective is study the cognitive impairment in older adults with arterial stroke. To study the relation between the cognitive impairment and disability. Method Sample includes patients above the age of 45 years with arterial stroke seeking treatment from NIMHANS outpatient departments. Ethical clearance was obtained. Patient underwent neurological examination. Standard instruments applied were Modified Rankin scale (MRS), Barthel index (BI), Stroke specific quality of life (SS‐QOL) and Addenbrooke’s cognitive examination (ACE‐III). Results 100 stroke patients were recruited as per the inclusion criteria. The sample included 75% males (M:F‐ 3:1), with mean age of 63.98 (SD‐8.45) years. Among them majority were living with spouse (87%), from urban background (75%) and 52% had education of high school and above. Median duration of stroke at assessment was 5 months. The mean score on MRS, BI and SS‐QOL were 2.12 (SD‐1.13), 82.0 (18.64) and 180 (SD‐35.175)respectively. Among our patients 10% meets criteria for vascular dementia and 20% for mild cognitive impairment.On ACE‐III the mean score was 65.50 (SD‐17.72) with score on Attention‐13.21 (SD‐4.54), Memory‐15.11 (SD‐7.07), Fluency‐5.63 (SD‐3.174), Language‐19.92 (SD‐5.59),Visuo‐spatial‐9.69 (SD‐4.51). There was positive correlation between ACE‐ III scores and Barthel index (r= 0.526; p<0.001)and SS‐QOL (r=0.716; P<0.001).There was negative correlation between ACE‐III score and MRS (r= ‐ 0.599; p<0.001). Conclusion In our study, one‐third of sample had cognitive impairment, at 5 months (median) after stroke.The prevalence of post stroke cognitive impairment is on the lower side as compared to recent meta‐analysis (Barbay et al., 2018; Merriman et al., 2019) which could be due to inclusion of outpatient sample and time of assessment. Cognitive impairment has negative impact of functioning and quality of life in stroke patients which is in agreement with previous studies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".