Evolving Profile and Determinants of Post-Stroke Cognitive Impairment in the 3rd Month among Kinshasa’s Survivors (Democratic Republic of the Congo)

Abstract

Background: Neurocognitive impairments are common among stroke survivors. Despite their negative impact on daily life, their evolving, and determinants are not fully known in our context. To determine evolving characteristics of post-stroke cognitive impairment in the 3rd month as well as determinants among Kinshasa’s adult survivors is the aim of this study. Methods: We sought to determine neurocognitive deficits in the 3rd month in a prospective single-group cohort study in 3 hospital centers in Kinshasa. Eighty-six adult stroke survivors with a neurological and neuroimaging computerized diagnosis of stroke were assessed using MOCA (Montreal Cognitive Assessment) in the first and the third months post-stroke. Results: Neurocognitive disorders ranged from 79.1% in the first month to 54.7% in the third month after stroke (with 4.7% with severe decline). Gender female [AOR = 86.3 (CI95%: 2.8 - 2643.7); p 0.01], Chronic hypertension ([AOR = 26.8 (CI95%: 2.55 - 282.55); p 0.01]), the pathological lipid profile [AOR = 8.7 (CI95%: 1.10 - 68.82); p = 0.04] and worse MOCA score at the first month ([AOR = 41.2 (CI95%: 8.13 - 2134.81); p = 0.021]) were identified as worse predictors of cognitive impairments at the third month post-stroke. Conclusion: Post-stroke cognitive impairment is common and decreases in the 3rd month post-stroke. Chronic hypertension, gender, lipid profile, and the first month MOCA score are predictors of worse cognitive performance in Kinshasa survivors. These findings suggested the role of early management in improving cognition and the control of stroke risk factors.