Post-Stroke Cognitive Disorders and Associated Factors in French Speaking West Africa, Benin Case

Dieu Donné Gnonlonfoun, Paul Macaire Ossou-Nguiet, Lansana Laho Diallo, Constant Adjien, Isaac Avlessi, Gérard Goudjinou, Octave Houannou, Dismand Houinato, Gilbert Dossou Avode

Neurology Department, Centre Hospitalier et Universitaire de Conakry, Conakry, Guinée.
Neurology Department, Centre Hospitalier et Universitaire of Brazzaville, Brazzaville, Congo.
Neurology Department, Centre National Hospitalier et Un-iversitaire Hubert Koutoukou MAGA de Cotonou (CNHU-HKM), Cotonou, Benin.

DOI: 10.4236/nm.2014.51006                

Abstract

Introduction: Cognitive disorders frequency arising after a cardio-cerebral vascular disease (stroke) is currently on the rise due to the ageing population and the increase in the number of survivors after stroke occurrence. Objective: Determining post-stroke cognitive decline and identifying associated factors. Method: It consists in a cross-sectional, prospective, descriptive and analytical study which was conducted from April 1 to August 31, 2013 in the Neurology Department of CNHU-HKM in Cotonou. The study involved 100 patients who have known stroke for at least the past 6 months and were all admitted and discharged later on. The disease survivors were re-contacted and examined again at home or at hospital. The cognitive decline (CD) was estimated by using a modified and adapted MMSE to suit our cultural era. Results: All patients were aged 58.9 years ± 13.6 years. Sex-ratio was 1.4. Cognitive decline frequency was 20%. Post-stroke cognitive decline frequency per sex was 11.6% and 8.4% respectively for females and males. Ischemia stroke patients had a higher cognitive decline (22.5%). 58.3% had severe CD. Moreover the CD frequency increased with time, from 16.7% in a year to 50% in 3 years. Total MMSE varied from 6 to 23 with 21 as median. From the unvaried analysis, the presence of sphincter disorders (1.26 [0.35-4.59], p = 0.004), consciousness disorders (15.67 [1.46-168], p = 0.04), and convulsion disorders (3.77 [1.01 -14.00], p = 0.003) was associated with cognitive decline. From multi-varied analysis, the sole presence of convulsive attacks (11.5 [1.79-73.58], p = 0.01) was individually associated with post-stroke cognitive decline. Conclusion: This study reveals the importance of CD after stroke. The occurrence of convulsions at stroke acute stage is a prognostic factor of CD medium or long-term occurrence. The overall coverage improvement depends on the integration of these data in stroke reach-out programs.

Keywords

Stroke; Cognitive Decline; Dementia; Benin

Conflicts of Interest

The authors declare no conflicts of interest.

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