Features of cognitive impairment and anxiety-depressive disorders in patients in the acute period of stroke

Abstract

Introduction. Cognitive impairment after a stroke remains one of the leading causes of disability. Despite the introduction of new methods of treatment, diagnosis, and prevention of acute vascular diseases, more than 50 % of patients experience cognitive disorders after a stroke, a third of which reach a severe degree of dementia. The purpose of the study is to identify and assess risk factors for the development of cognitive impairment disorders in patients after a stroke and evaluate the impact of anxiety and depressive phenomena on their course. Materials and methods. The combined retro-prospective study included 40 patients with mild stroke according to the NIHSS. The diagnosis of stroke in all subjects was verified based on the results of MSCT of the brain. All patients underwent a comprehensive clinical and laboratory monitoring: a general examination; an assessment of neurological and functional status; an assessment of cognitive functions and mental status by MMSE scale and the Frontal Assessment Battery; an assessment of anxiety-depressive disorders by the Spielberger State-Trait Anxiety Inventory, the Beck Depression Inventory, and the Hamilton Rating Scale. The influence of individual risk factors on the development of cognitive impairment was evaluated. Results. More than 80 % of the patients with mild stroke in the acute period experienced a decrease in cognitive functions, while 62 % of the subjects showed signs of frontal dementia of varying severity. In the presence of high comorbidity with forms of the circulatory system pathologies (hypertension, diabetes, atrial fibrillation, coronary heart disease), there was a high frequency of both frontal dementia (in 87 % of the patients), and a decrease in cognitive functions on the MMSE scale (67 % of cases). All patients were diagnosed with depression, and half of them — with severe depression. 80 % of the patients with severe depression had severe cognitive changes on the MMSE scale, and 75 % had severe frontal dysfunction. Conclusion. Thus, high vascular comorbidity and the presence of anxiety and depressive disorders are significant risk factors for the development of cognitive impairment after a stroke. In this regard, measures aimed at their timely detection, treatment, and correction will make it possible to effectively reduce the incidence of post-stroke cognitive impairment, which, in turn, will improve the quality of life not only for the patients themselves but also for their relatives.