Screening of vascular cognitive impairment on a Hungarian cohort

Cerebrovascular disease is a major public health problem in Eastern Europea n countries. A Hungarian post-stroke population was examined to estimate th e rate of dementia, the risk factors for cognitive impairment, and the appl icability of a recently established Canadian diagnostic checklist in this c ohort. Chronic cerebrovascular outpatients were screened for cognitive impa irment with a combined checklist: the Diagnostic Checklist for Vascular Dem entia established by the Consortium of Canadian Centres for Clinical Cognit ive Research using the Mini Mental State Examination instead of the detaile d neuropsychological part of the Checklist. Of the 247 consecutive patients at a cerebrovascular outpatient unit, 176 had cerebrovascular disorder dia gnosed either by computed tomography (CT; n=126) or by the clinical signs. Of these, 15% were cognitively impaired and 5% fulfilled the criteria of de mentia. The mean age of the patients with cognitive impairment was signific antly higher than that of patients with normal cognition (68.2 +/- 10.2 and 60.5 +/- 10.5 years, P < 0.001). The Barthel index was significantly lower in the cognitively affected group than in non-affected patients (92.4 +/- 16.0 and 97.1 +/- 8.7, P = 0.027). Diabetes and more than two subcortical i nfarcts on CT or magnetic resonance imaging were more frequent in patients with cognitive loss (P = 0.043 and P = 0.013, respectively). Cognitive perf ormance was also influenced by the level of education. Higher age, diabetes , motor deficits, and multiple subcortical infarcts are risk factors for co gnitive impairment after stroke. The combined checklist appears to be a pra ctical screening test for cognitive impairment in patients with chronic cer ebrovascular diseases.