Open AccessCognitive performance following lacunar stroke in S panish‐speaking patients: results from the SPS 3 trial
Author(s) -
Jacova Claudia,
Pearce Lesly A.,
Roldan Ana M.,
Arauz Antonio,
Tapia Jorge,
Costello Raymond,
McClure Leslie A.,
Hart Robert G.,
Benavente Oscar R.
Publication year - 2015
Publication title -
international journal of stroke
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.375
H-Index - 74
eISSN - 1747-4949
pISSN - 1747-4930
DOI - 10.1111/ijs.12511
Subject(s) - medicine , neuropsychology , cognitive impairment , cognition , latin americans , memory impairment , audiology , stroke (engine) , pediatrics , psychiatry , linguistics , mechanical engineering , philosophy , engineering
Background Cognitive impairment is frequent in lacunar stroke patients. The prevalence and pattern among S panish‐speaking patients are unknown and have not been compared across regions or with E nglish‐speaking patients. Aims The aim of this study was to characterize cognitive impairment in S panish‐speaking patients and compare it with E nglish‐speaking patients. Methods The baseline neuropsychological test performance and the prevalence of mild cognitive impairment, defined as a z‐score ≤ −1·5 on memory and/or non‐memory tests, were evaluated in S panish‐speaking patients in the S econdary P revention of S mall S ubcortical S trokes trial. Results Out of 3020 participants, 1177 were S panish‐speaking patients residing in L atin A merica ( n = 693), the U nited S tates ( n = 121), and S pain ( n = 363). Low education (zero‐ to eight‐years) was frequent in S panish‐speaking patients (49–57%). L atin A merican S panish‐speaking patients had frequent post‐stroke upper extremity motor impairment (83%). Compared with E nglish‐speaking patients, all S panish‐speaking patient groups had smaller memory deficits and larger non‐memory/motor deficits, with L atin A merican S panish‐speaking patients showing the largest deficits median z‐score −1·3 to −0·6 non‐memory tests; ≤5·0 for Grooved Pegboard; −0·7 to −0·3 for memory tests). The prevalence of mild cognitive impairment was high and comparable with E nglish‐speaking patients in the U nited S tates and L atin A merican S panish‐speaking patients but not the S panish group: E nglish‐speaking patients = 47%, L atin A merican S panish‐speaking patients = 51%, US S panish‐speaking patients = 40%, Spanish S panish‐speaking patients = 29%, with >50% characterized as non‐amnestic in S panish‐speaking patient groups. Older age [odds ratio per 10 years = 1·52, confidence interval = 1·35–1·71), lower education (odds ratio 0–4 years = 1·23, confidence interval = 0·90–1·67), being a L atin A merican resident (odds ratio = 1·31, confidence interval = 0·87–1·98), and post‐stroke disability (odds ratio B arthel I ndex <95 = 1·89, confidence interval = 1·43–2·50) were independently associated with mild cognitive impairment. Conclusions Mild cognitive impairment in S econdary P revention of S mall S ubcortical S trokes S panish‐speaking patients with recent lacunar stroke is highly prevalent but has a different pattern to that observed in E nglish‐speaking patients. A combination of socio‐demographics, stroke biology, and stroke care may account for these differences.