부산대학교 도서관

Objective: To study the relationship between cognitive reserve (CR) and cognitive deficit (CD) in patients who have suffered a stroke. Design: A cross-sectional study was conducted on 103 patients who suffered a stroke between 10/01/2010 and 29/02/2012. Material and methods: The study included patients with more than one month's evolution. Patients excluded were aphasic patients, those with previous mental illness and patient's who died. The following were evaluated in 36 patients: CR using the Cognitive Reserve Questionnaire, CD Mini-Mental State Examination (MMSE), type of stroke according to the Oxfordshire Community Stroke Project classification, initial severity level by the National Institute of Health Stroke Scale (NIHSS), age, evolution time, sex, etiology, and side affected by stroke, cultural level and functional capacity measured with Barthel index. The Student's t test and chi-square test were used according to the variable and the non-parametric test if the distribution was not normal (Kolmogorov-Smirnov). Linear and logistic regression were used to quantify the relation and to determine the odds ratio (95% CI). A P<.05 was considered. Results: Average CR 9 (SD: 5.4) was 9 points and MMSE 25.9 (SD: 4.9) points. Low CR was found in 55.6% and 38.9% had severe CD. There was a linear relation between CR and MMSE (R=0.65, P<.0001). After adjusting for variables, the model including NIHSS and age, MMSE decreased 0.34 (95% CI: 0.61-0.07) and 0.13 (95% CI: 0.25-0.004), respectively, per unit and accounts for 53.5% of CD. Patient with high CR had mild CD. The risk of severe CD is determined by low CR (OR: 5.3; 95% CI: 1.1-24.5) and older age. Conclusion: There is relationship between CR and CD. The presence of severe CD is 5 times higher when the CR is low and increases 1.1 per year of age.