Effect of Cognitive Reserve on Risk of Cognitive Impairment and Recovery After Stroke The KOSCO Study
- 주제(키워드) cognitive dysfunction , cognitive reserve , education , longitudinal studies , occupation , risk factors , stroke
- 주제(기타) Clinical Neurology; Peripheral Vascular Disease
- 설명문(일반) [Shin, Minyoung; Chang, Won Hyuk; Shin, Min A.; Kim, Yun-Hee] Sungkyunkwan Univ, Ctr Prevent & Rehabil, Samsung Med Ctr, Heart Vasc Stroke Inst,Dept Phys & Rehabil Med,Sc, Seoul, South Korea; [Shin, Minyoung] Yongmoon Grad Sch Counseling Psychol, Dept Counseling Psychol, Seoul, South Korea; [Sohn, Min Kyun] Chungnam Natl Univ, Sch Med, Dept Rehabil Med, Daejeon, South Korea; [Lee, Jongmin] Konkuk Univ, Dept Rehabil Med, Sch Med, Seoul, South Korea; [Kim, Deog Young] Yonsei Univ, Dept & Res Inst Rehabil Med, Coll Med, Seoul, South Korea; [Lee, Sam-Gyu] Chonnam Natl Univ, Dept Phys & Rehabil Med, Med Sch, Kwangju, South Korea; [Shin, Yong-Il] Pusan Natl Univ, Sch Med, Dept Rehabil Med, Yangsan Hosp, Busan, South Korea; [Oh, Gyung-Jae] Wonkwang Univ, Sch Med, Dept Prevent Med, Iksan, South Korea; [Lee, Yang-Soo] Kyungpook Natl Univ, Sch Med, Dept Rehabil Med, Daegu, South Korea; [Joo, Min Cheol] Wonkwang Univ, Dept Rehabil Med, Sch Med, Iksan, South Korea; [Han, Eun Young] Jeju Natl Univ, Dept Rehabil Med, Sch Med, Jeju City, South Korea; [Ahn, Jeonghoon] Hallym Univ, Dept Stat, Chunchon, South Korea; [Ahn, Jeonghoon] Ewha Womans Univ, Dept Hlth Convergence, Seoul, South Korea; [Choi, Ji Yoo; Kang, Sung Hyun] Korea Ctr Dis Control & Prevent, Ctr Dis Prevent, Div Chron Dis Prevent, Osong, South Korea; [Kim, Youngtaek] Chungnam Natl Univ Hosp, Publ Hlth Med Serv, Daejeon, South Korea; [Kim, Yun-Hee] Sungkyunkwan Univ, Dept Hlth Sci & Technol, Dept Med Device Management & Res, Dept Digital Healthcare,SAIHST, Seoul, South Korea
- 등재 SCIE, SCOPUS
- OA유형 hybrid, Green Published
- 발행기관 LIPPINCOTT WILLIAMS & WILKINS
- 발행년도 2020
- URI http://www.dcollection.net/handler/ewha/000000165918
- 본문언어 영어
- Published As http://dx.doi.org/10.1161/STROKEAHA.119.026829
- PubMed https://pubmed.ncbi.nlm.nih.gov/31822247
초록/요약
Background and Purpose- The theory of cognitive reserve (CR) was introduced to account for individual differences in the clinical manifestation of neuropathology. This study investigated whether CR has a modulating effect on cognitive impairment and recovery after stroke. Methods- This study is an interim analysis of the Korean Stroke Cohort for Functioning and Rehabilitation. A total of 7459 patients with first-ever stroke were included for analysis. Education, occupation, and composite CR scores derived from those 2 variables were used as CR proxies. Scores from the Korean version of the Mini-Mental State Examination analyzed for 30 months after stroke onset were analyzed. Results- Lower CR increased the risk of cognitive impairment after stroke. The odds ratio was 1.89 (95% CI, 1.64-2.19) in patients with secondary education and 2.42 (95% CI, 2.03-2.90) in patients with primary education compared with patients with higher education. The odds ratio was 1.48 (95% CI, 1.23-1.98) in patients with a skilled manual occupation and 2.01 (95% CI, 1.42-2.83) in patients with a nonskilled manual occupation compared with patients with a managerial or professional occupation. In the multilevel model analysis, the Korean version of the Mini-Mental State Examination total score increased during the first 3 months (1.93 points per month) and then plateaued (0.02 point per month). The slopes were moderated by the level of education, occupation, and composite CR score: the higher the level of education, occupation, or CR score, the faster the recovery. In the older adult group, the Korean version of the Mini-Mental State Examination scores showed a long-term decline that was moderated by education level. Conclusions- Education and occupation can buffer an individual against cognitive impairment caused by stroke and promote rapid cognitive recovery early after stroke. In addition, higher education minimizes long-term cognitive decline after stroke, especially in older patients.
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