Incidence of cognitive impairment post first stroke: a systematic review and meta-analysis

首次卒中后认知障碍的发生率:系统评价和荟萃分析

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Abstract

OBJECTIVE: To clarify the incidence of post-stroke cognitive impairment (PSCI) in first-time stroke patients through meta-analysis. METHODS: We conducted a comprehensive search of PubMed, Embase, Web of Science, and the Cochrane Library for studies reporting PSCI incidence up to May 5, 2024. Pooled incidence was calculated using Stata 18.0 with a random-effects model. RESULTS: A total of 11 publications from six countries with a sample population of 7,048 were included in the final analysis. The overall incidence of PSCI in first-time stroke patients was estimated to be 46% [95% CI (36-57), I (2) = 98.63%]. Subgroup analysis showed that the prevalence of PSCI was 38% in male and 45% in female; The prevalence of PSCI was 54% for hemorrhagic stroke and 44% for ischemic stroke; The prevalence of PSCI was 38% in stroke patients possessing hypertension and 32% in stroke patients without hypertension; The prevalence of PSCI was 44% in stroke patients with diabetes and 36% in stroke patients without diabetes; The prevalence of PSCI was 46% in stroke patients with hyperlipidemia and 40% in stroke patients without hyperlipidemia; The incidence of PSCI in stroke patients aged > 60 years was 44%. CONCLUSION: Nearly half of patients with first-time stroke develop PSCI and the rate is higher in females, patients aged > 60 years, hemorrhagic stroke subtype, and those with hypertension, diabetes, and hyperlipidemia compared to males, ischemic stroke subtype, and those without underlying diseases. SYSTEMATIC REVIEW REGISTRATION: The protocol for this review was registered with the PROSPERO International Prospective Register of Systematic Reviews (CRD42024611457).

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