A simple
drawing test can predict the long-term risk of dying after a first
stroke among older men, according to research published in the online
journal BMJ Open.
Despite treatment advances, stroke is still a leading cause of death and disability, with older age and impaired cognitive function before a stroke associated with higher risks of death and disability afterwards.
The researchers wanted to see if there was a reliable way of finding out who might be most at risk of a stroke death, based on cognitive function, so they analysed data from the Uppsala Longitudinal Study of Adult Men, which has been looking at different risk factors for heart disease and stroke in 2,322 men since the age of 50.
Just under 1,000 of these men, who had not been diagnosed with stroke and whose intellectual capacity was assessed when they were aged between 65 and 75, completed both the Trail Making Test (TMT), and the mini mental state exam (MMSE), which is widely used to test for dementia.
The TMT involves drawing lines with a pencil between numbers and/or letters in ascending order, as quickly as possible, while the MMSE sets participants general cognitive tasks such as orientation, memory, and numeracy.
During the 14-year monitoring period from 1991 to 2006, 155 men had a first major or transient ischaemic attack. Just over half of them died within an average of 2.5 years, with 22 dying within a month of their stroke.
After taking account of known risk factors, such as older age, high blood pressure, education and social background, those who had performed badly in the TMT were more likely to have died.
Men whose scores were in the bottom 30% were around three times as likely to have died after their stroke as those who were in the highest 30%. No such association was seen among those with poor MMSE scores.
Dr Bernice Wiberg, from the Department of Public Health and Caring Sciences/Geriatrics at Uppsala University in Sweden said TMT is likely to pick up latent cognitive impairments, caused by silent cerebrovascular disease that has not yet produced overt symptoms.
He added that TMT “may not only be used as tools for identifying risk of stroke, but may also be considered important predictors of post stroke mortality.”
Despite treatment advances, stroke is still a leading cause of death and disability, with older age and impaired cognitive function before a stroke associated with higher risks of death and disability afterwards.
The researchers wanted to see if there was a reliable way of finding out who might be most at risk of a stroke death, based on cognitive function, so they analysed data from the Uppsala Longitudinal Study of Adult Men, which has been looking at different risk factors for heart disease and stroke in 2,322 men since the age of 50.
Just under 1,000 of these men, who had not been diagnosed with stroke and whose intellectual capacity was assessed when they were aged between 65 and 75, completed both the Trail Making Test (TMT), and the mini mental state exam (MMSE), which is widely used to test for dementia.
The TMT involves drawing lines with a pencil between numbers and/or letters in ascending order, as quickly as possible, while the MMSE sets participants general cognitive tasks such as orientation, memory, and numeracy.
During the 14-year monitoring period from 1991 to 2006, 155 men had a first major or transient ischaemic attack. Just over half of them died within an average of 2.5 years, with 22 dying within a month of their stroke.
After taking account of known risk factors, such as older age, high blood pressure, education and social background, those who had performed badly in the TMT were more likely to have died.
Men whose scores were in the bottom 30% were around three times as likely to have died after their stroke as those who were in the highest 30%. No such association was seen among those with poor MMSE scores.
Dr Bernice Wiberg, from the Department of Public Health and Caring Sciences/Geriatrics at Uppsala University in Sweden said TMT is likely to pick up latent cognitive impairments, caused by silent cerebrovascular disease that has not yet produced overt symptoms.
He added that TMT “may not only be used as tools for identifying risk of stroke, but may also be considered important predictors of post stroke mortality.”
Source :
http://www.onmedica.comhttp://bmjopen.bmj.com/content/2/3
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