Simple test may help predict long-term outcome after stroke

Oct 17, 2018

A simple test taken within a week of a stroke may help predict how well people will have recovered up to three years later, according to a study published in the October 17, 2018, online issue of Neurology®, the medical journal of the American Academy of Neurology.

"We found that this test, which takes less than 10 minutes, can help predict whether people will have impaired thinking skills, problems that keep them from performing daily tasks such as bathing and dressing and even whether they will be more likely to die," said study author Martin Dichgans MD, of Ludwig-Maximilians University in Munich, Germany. "This test should be used to screen people with stroke and to counsel them and their families about long-term prognosis and also to identify those who would most benefit from interventions that could improve their outcomes."

For the study, 274 people in Germany and France who had a stroke were given the test, called the Montreal Cognitive Assessment, within a week of the stroke. They were then divided into 2 groups: those with no problems with thinking and memory skills and those with cognitive impairment. The participants were tested for their thinking and memory skills, motor functioning and ability to complete daily living tasks six months later and then at 1 and 3 years after the stroke.

The study found that those who had thinking problems within one week of the stroke were seven times more likely to die during the 3 years of the study than those who did not have thinking problems. The survival rate for those with thinking problems after three years was 83%, while the rate was 97% for those with no thinking problems early on.

Those with thinking problems on the first test were also 5  times more likely to have problems with their motor skills than those who did not have thinking problems early on. By 3 years after the stroke, 29% of those with thinking problems on the first test had problems with their motor skills, compared to 5% of those who did not have thinking problems early on.

Those with cognitive impairment were more than twice as likely to have problems completing their daily activities such as bathing and dressing, with 42% having problems compared to 13% three years after the stroke.

Those with cognitive impairment were 5 times more likely to continue having thinking problems three years after the stroke than the other group.

Dichgans noted that the test helped predict outcomes even when other factors such as the severity of the stroke were taken into account.

A limitation of the study was that most of the people involved had relatively mild strokes, so more research is needed to determine whether the results apply to people with more severe strokes.

Source: News Release
American Academy of Neurology
October 17, 2018