THỰC TRẠNG RỐI LOẠN NHẬN THỨC VÀ CÁC YẾU TỐ LIÊN QUAN Ở NGƯỜI CAO TUỔI SAU ĐỘT QUỴ NÃO

Abstract

Objectives: To describe the current status of cognitive impairment and identify associated factors in older adults after stroke. Methods: A cross-sectional study was conducted in 188 post-stroke patients aged ≥60 years. Cognitive function was assessed using the MMSE. Clinical and functional variables were collected using NIHSS, ADL, IADL, CFS, GDS, PSQI, and comorbidity data. Multivariable linear regression was performed to determine independent factors associated with MMSE scores. Results: Mean age was 79 ± 10 years; 54.3% were male. Mean NIHSS and MMSE scores were 15 ± 11 and 15 ± 7.6, respectively. The prevalence of cognitive impairment was 76.6%, with moderate and severe levels being most common (30.9% and 35.1%). Stroke severity and functional decline increased with worsening cognitive impairment (p < 0.001). Frailty, depressive symptoms, and sleep disturbances were more frequent in severe impairment. No significant differences were found regarding stroke type or cardiovascular comorbidities. Multivariable analysis showed NIHSS (β = −0.32; p < 0.001) and GDS (β = −0.26; p = 0.044) were negatively associated, while IADL was positively associated (β = 0.72; p = 0.011) with MMSE scores. Conclusions: Cognitive impairment is highly prevalent in older adults after stroke. Stroke severity, impaired instrumental daily activities, and depressive symptoms are independently associated with cognitive function. Early screening and management of cognitive impairment are essential in this population.