Analysis of the effectiveness of structured cognitive rehabilitation therapy in post-stroke cognitive impairment patients in Singapore
10.3969/j.issn.1002-0152.2024.04.001
- VernacularTitle:结构化认知康复治疗在新加坡脑卒中后认知功能障碍患者中的应用效果分析
- Author:
Yijin LEOW
1
,
2
;
Chao DANG
;
Nagaendran KANDIAH
Author Information
1. 南洋理工大学李光前医学院,新加坡失智症中心(新加坡 308232)
2. 新加坡国立大学杜克医学院
- Keywords:
Cerebrovascular disease;
Post stroke cognitive impairment;
Ischemic stroke;
Cognitive rehabilitation;
Cognition
- From:
Chinese Journal of Nervous and Mental Diseases
2024;50(4):193-208
- CountryChina
- Language:Chinese
-
Abstract:
Objective Literature on cognitive prognoses in association with stroke-related and pre-stroke factors,are surprisingly meagre.Prognoses of patients with post stroke cognitive impairment(PSCI)to structured cognitive rehabilitation are not clearly understood.This study aimed to compare if the prognoses of stroke survicors after cognitive rehabilitation programme was associated with chronic cerebrovascular disease(CVD).Methods An eight-week non-pharmacological clinical programme was ran for patients with mild strokes to provide clinical support to stroke patients and collect longitudinal data on stroke prognoses.149 ischemic stroke survivors(age 63.6±9.66,64.4%males)underwent an eight-week structured group cognitive rehabilitation programme.Baseline,immediate post programme(Immediate-PP)and 6-month post programme(6-month-PP)global cognitive and quality of life outcomes were assessed by Montreal cognitive assessment(MoCA)and dementia-quality of life instrument(DemQOL).Regression analyses evaluated the influence of cognitive rehabilitation on outcomes.Results With every past stroke experienced by patients,they were less likely to demonstrate an improvement in MoCA score Immediate-PP(OR=2.17,95%CI:0.980-4.813,P=0.056).Patients with severe white matter hyperintensities were less likely to demonstrate an improvement in MoCA scores Immediate-PP compared to Baseline(OR=2.13,95%CI:1.04-4.38,P=0.039).Finally,patients with microhemorrhages in the deep region were less likely to demonstrate an improvement in MoCA at 6-month-PP(OR=19.93,95%CI:1.04-384,P=0.047).Conclusions Pre-stroke CVD is associated with poorer cognitive outcomes post cognitive rehabilitation.Our initial programme shows promising results-however further research into cognitive rehabilitation for stroke survivors with pre-stroke CVD is needed.The findings from our clinical rehabilitation programme will be useful guiding the design of a clinical trial.
