{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T03:18:39Z","timestamp":1792034319646,"version":"4.4.0"},"reference-count":68,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,1,7]]},"abstract":"\n Background<\/jats:title>\n It is likely that a proportion of poststroke cognitive impairment is sometimes attributable to unidentified prestroke decline; prestroke cognitive function is also clinically relevant because it is associated with poor functional outcomes, including death. We investigated the radiological and prognostic associations of preexisting cognitive impairment in patients with ischemic stroke or transient ischemic attack associated with atrial fibrillation.<\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We included 1102 patients from the prospective multicenter observational\n CROMIS<\/jats:styled-content>\n \u20102 (Clinical Relevance of Microbleeds in Stroke 2) atrial fibrillation study. Preexisting cognitive impairment was identified using the 16\u2010item Informant Questionnaire for Cognitive Decline in the Elderly. Functional outcome was measured using the modified Rankin scale. Preexisting cognitive impairment was common (n=271; 24.6%). The presence of lacunes (odds ratio [OR], 1.50; 95%\n CI<\/jats:styled-content>\n , 1.03\u20131.05;\n P<\/jats:italic>\n =0.034), increasing periventricular white matter hyperintensity grade (per grade increase,\n OR<\/jats:styled-content>\n , 1.38; 95%\n CI<\/jats:styled-content>\n , 1.17\u20131.63;\n P<\/jats:italic>\n <0.0001), deep white matter hyperintensity grade (per grade increase,\n OR<\/jats:styled-content>\n , 1.26; 95%\n CI<\/jats:styled-content>\n , 1.05\u20131.51;\n P<\/jats:italic>\n =0.011), and medial temporal atrophy grade (per grade increase,\n OR<\/jats:styled-content>\n , 1.61; 95%\n CI<\/jats:styled-content>\n , 1.34\u20131.95;\n P<\/jats:italic>\n <0.0001) were independently associated with preexisting cognitive impairment. Preexisting cognitive impairment was associated with poorer functional outcome at 24\u00a0months (\n mRS<\/jats:styled-content>\n >2; adjusted\n OR<\/jats:styled-content>\n , 2.43; 95%\n CI<\/jats:styled-content>\n , 1.42\u20134.20;\n P<\/jats:italic>\n =0.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Preexisting cognitive impairment in patients with atrial fibrillation\u2013associated ischemic stroke or transient ischemic attack is common, and associated with imaging markers of cerebral small vessel disease and neurodegeneration, as well as with longer\u2010term functional outcome.<\/jats:p>\n <\/jats:sec>\n \n Clinical Trial Registration<\/jats:title>\n \n URL<\/jats:styled-content>\n :\n http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n . Unique identifier:\n NCT<\/jats:styled-content>\n 02513316.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.119.014537","type":"journal-article","created":{"date-parts":[[2020,1,4]],"date-time":"2020-01-04T10:00:22Z","timestamp":1578132022000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":27,"title":["Cognitive Impairment Before Atrial Fibrillation\u2013Related Ischemic Events: Neuroimaging and Prognostic Associations"],"prefix":"10.1161","volume":"9","author":[{"given":"Gargi","family":"Banerjee","sequence":"first","affiliation":[{"name":"Department of Brain Repair and Rehabilitation Stroke Research Centre UCL Queen Square Institute of Neurology and the National Hospital for Neurology and Neurosurgery London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Neuropsychology National Hospital for Neurology and Neurosurgery Queen Square London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gareth","family":"Ambler","sequence":"additional","affiliation":[{"name":"Department of Statistical Science University College London London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duncan","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Brain Repair and Rehabilitation Stroke Research Centre UCL Queen Square Institute of Neurology and the National Hospital for Neurology and Neurosurgery London United Kingdom"},{"name":"New Zealand Brain Research Institute Christchurch New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Cipolotti","sequence":"additional","affiliation":[{"name":"Department of Neuropsychology National Hospital for Neurology and Neurosurgery Queen Square London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"Shakeshaft","sequence":"additional","affiliation":[{"name":"Department of Brain Repair and Rehabilitation Stroke Research Centre UCL Queen Square Institute of Neurology and the National Hospital for Neurology and Neurosurgery London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Cohen","sequence":"additional","affiliation":[{"name":"Haemostasis Research Unit Department of Haematology University College London London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarek","family":"Yousry","sequence":"additional","affiliation":[{"name":"Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit Department of Brain Repair and Rehabilitation UCL Queen Square Institute of Neurology Queen Square London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rustam","family":"Al\u2010Shahi Salman","sequence":"additional","affiliation":[{"name":"Centre for Clinical Brain Sciences School of Clinical Sciences University of Edinburgh United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Y. 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