{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T21:15:36Z","timestamp":1790025336634,"version":"4.0.1"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Some patients with stroke have prestroke cognitive impairment (pre-SCI), but its etiology is not clear. The aim of this cross-sectional study was to assess the frequency of pre-SCI and its association with premorbid neuropsychiatric, functional, and neuroimaging features.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>Patients hospitalized in stroke unit with an informant who could complete IQCODE (Informant Questionnaire for Cognitive Decline in the Elderly) were included. Pre-SCI was diagnosed if the IQCODE score was &gt;3.3. Prestroke assessment also included NPI-Q (Neuropsychiatric Inventory Questionnaire), the basic Activities of Daily Living and Instrumental Activities of Daily Living scales, and the Clinical Dementia Rating scale. A multivariate logistic regression model was used to evaluate the association of pre-SCI with age, sex, education, arterial hypertension, atrial fibrillation, white matter lesions, cerebral microbleeds, and pathological medial temporal lobe atrophy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              IQCODE was available in 474 of 520 patients (91.2%; 45% women; mean age 75.5\u00b113.3 years). Pre-SCI had a prevalence of 32.5% and was associated with prestroke NPI-Q (pre-SCI absent versus present, 1.7\u00b12.3 versus 5.5\u00b14.9;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001), Activities of Daily Living scale (0.3\u00b10.8 versus 1.8\u00b11.9;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001), Instrumental Activities of Daily Living scale (0.6\u00b11.3 versus 3.8\u00b14.0;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001), and Clinical Dementia Rating scale score (0.7\u00b11.7 versus 7.2\u00b16.2;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001). In the 271 patients with a magnetic resonance imaging available, the multivariate logistic regression showed that age (odds ratio [OR], 1.05 [95% CI, 1.62\u20139.73]), white matter lesions (OR, 1.26 [95% CI, 1.003\u20131.58]), and a pathological medial temporal lobe atrophy score (OR, 3.97 [95% CI, 1.62\u20139.73]) were independently associated with pre-SCI. In the 218 patients with ischemic stroke, white matter lesions (OR, 1.34 [95% CI, 1.04\u20131.72]) and medial temporal lobe atrophy (OR, 3.56 [95% CI, 1.38\u20139.19]), but not age, were associated with pre-SCI.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>One-third of patients admitted to a stroke unit have pre-SCI that is associated with preexisting neuropsychiatric symptoms and functional performance. White matter lesions and medial temporal lobe atrophy are associated with pre-SCI, suggesting that both small vessel disease and neurodegeneration might be involved in its etiology.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.123.045344","type":"journal-article","created":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T09:01:52Z","timestamp":1717146112000},"page":"1869-1876","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Prestroke Cognitive Impairment: Frequency and Association With Premorbid Neuropsychiatric, Functional, and Neuroimaging Features"],"prefix":"10.1161","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0324-2518","authenticated-orcid":true,"given":"Francesco","family":"Mele","sequence":"first","affiliation":[{"name":"Neurology Unit, Luigi Sacco University Hospital, Milan, Italy (F. Mele, I.C., A.N., G.M., V.C., S.P., L.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Cova","sequence":"additional","affiliation":[{"name":"Neurology Unit, Luigi Sacco University Hospital, Milan, Italy (F. Mele, I.C., A.N., G.M., V.C., S.P., L.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2790-0796","authenticated-orcid":true,"given":"Alessia","family":"Nicotra","sequence":"additional","affiliation":[{"name":"Neurology Unit, Luigi Sacco University Hospital, Milan, Italy (F. Mele, I.C., A.N., G.M., V.C., S.P., L.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Maestri","sequence":"additional","affiliation":[{"name":"Neurology Unit, Luigi Sacco University Hospital, Milan, Italy (F. Mele, I.C., A.N., G.M., V.C., S.P., L.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0404-0053","authenticated-orcid":true,"given":"Emilia","family":"Salvadori","sequence":"additional","affiliation":[{"name":"Department of Clinical and Biomedical Sciences, Neuroscience Research Center, University of Milan, Italy (E.S., F. Masserini, M.M., P.B., L.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Cucumo","sequence":"additional","affiliation":[{"name":"Neurology Unit, Luigi Sacco University Hospital, Milan, Italy (F. Mele, I.C., A.N., G.M., V.C., S.P., L.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0746-7426","authenticated-orcid":true,"given":"Federico","family":"Masserini","sequence":"additional","affiliation":[{"name":"Department of Clinical and Biomedical Sciences, Neuroscience Research Center, University of Milan, Italy (E.S., F. 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