Cerebrovascular disease with and without stroke: Cognitive and clinical profiles

Abstract

Cerebrovascular disease (CVD) patients with and without stroke were compared using clinical and neurological criteria, Magnetic Resonance Imaging (MRI) and cognitive impairment including dementia. The sample comprised 143 CVD outpatients (86 males, 60.14%): Stroke (n=88), Non-Stroke (n=55). Neurological and MRI assessment, the Clinical Dementia Rating (CDR: Normal, Questionable, non-demented; and Mild, Moderate, demented); the Alzheimer`s Disease Assessment Scale (ADAS-Cog), and the Trail Making Tests A (TMT-A) and B (TMT-B) were performed in all patients. Clinical, neurological and MRI results yielded statistically significant differences between patient groups (0.0001<P<0.05). Under Normal, Questionable and Mild CDR stages the Stroke group performed ADAS-Cog significantly worse (P<0.0001), showing non-significant differences in the Moderate stage. TMT time was always greater in the Stroke patients, while TMT errors resulted significantly greater in the Non-Stroke patient group (0.0001<P<0.002). The TMT-B/TMT-A ratio and the difference (B-A) were greater in the Non-Stroke patients (0.0001<P<0.001). At Moderate CDR the TMT’s showed no differences. Stroke and Non-Stroke CVD patients behave differently concerning several clinical, neurological and MRI results. Cognitive tests differ between groups when impairment has not reached the Moderate stage; further evolution turns both groups undistinguishable. Functional and cognitive impairment present a convincing linear association.