Prevalence and Associated Factors of Cognitive Impairment Among Stroke Survivors at Comprehensive Specialized Hospitals in Northwest Ethiopia: Multi-Centered Cross-Sectional Study

Abstract

Background

Deficit in cognitive impairment is the most serious of the stroke sequelae. Post-stroke cognitive impairment is associated with impaired daily living activities and decreased capacity for independent living and functional performance. As a result, the purpose of this study was to determine the prevalence and associated factors of cognitive impairment among stroke survivors at comprehensive specialized hospitals in Ethiopia’s Amhara region by 2022.

Methods

A multi-centered cross-sectional study was designed at an institution. During the study period. Data was gathered by conducting structured questionnaire interviews with participants and reviewing medical charts with trained data collectors. The participants were chosen using a systematic random sampling technique. The Montreal cognitive assessment basic was used to assess cognitive impairment. Descriptive statistics, binary and multivariate logistic regression methods were used to analyze the data. The Hosmer-Lemeshow goodness-of-fit test was used to assess the fitness of the model. The AOR with a P value of 0.05 at 95% CI was reported, and variables were considered statistically significant.

Results

This study enrolled 422 stroke survivors. Overall, 58.3% of stroke survivors had cognitive impairment (95% CI 53.4–63.0%). The study participants’ age with AOR; 7.12 (4.40–11.45), being hypertensive with AOR; 7.52 (3.46–16.35), arriving at the hospital after 24 hours with AOR; 4.33 (1.49–12.05), less than three months after stroke with AOR; 4.83 (3.95–12.19), dominant hemisphere lesion with AOR; 4.83 (3.95–12.19) and being illiterate with AOR; 5.26 (4.43–18.64) were found significant factors.

Conclusion

Cognitive impairment was discovered to be relatively common among stroke survivors in this study. More than half of stroke survivors who attended comprehensive specialized hospitals during the study period were found to have cognitive impairment. Age, hypertension, arriving at the hospital after 24 hours, less than three months after stroke, dominant hemisphere lesion, and illiterate educational status were all significant factors in cognitive impairment.

Keywords:

• - cognitive impairment
• prevalence
• stroke survivors
• Ethiopia

Abbreviations

Cerebrovascular Accident (CVA): WHO stands for World Health Organization. Cognitive Impairment (CI), PSCI is an acronym for Post Stroke Cognitive Impairment. MOCAB is an abbreviation for Montreal Cognitive Assessment Basic. COR stands for Crude Odds Ratio, and AOR stands for Adjusted Odds Ratio. Ethiopian Birr (ETB): DM stands for Diabetes Mellitus. HTN stands for high blood pressure. SPSS is an abbreviation for Statistical Package for Social Sciences. FHCSH: Felege Hiwot Comprehensive Specialized Hospital, DCSH: Dessie Comprehensive Specialized Hospital.

Data Sharing Statement

The data of this study can be available for reasonable request from the corresponding author.

Ethical Approval and Consent to Participate

The proposal was reviewed and approved by the Research and Ethical Review Committee of the Institutional Review Board (IRB) of the University of Gondar, College of Medicine and Health Science, and ethical clearance was obtained. The study’s objectives and significance were explained to the participants, and each participant provided informed consent. The study’s confidentiality was maintained at all levels. Participants’ participation in the study was voluntary; those who were unwilling to participate in the study or who wished to withdraw at any time were informed that they could do so without restriction. Participants in the study were identified using codes to ensure confidentiality, and no unauthorized individuals had access to the collected data. Only the principal investigator had access to the computerized data. All the data were carried out in this study have been conducted with the accordance to the principles of Helsinki declaration.

Acknowledgment

We are grateful to college of medicine and health sciences, University of Gondar for funding the project. We would like to express our special thanks to all study participants for giving their willingness and time during data collection.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

All the authors declared that they have no competing interests in this work.

Additional information

Funding

Our source of fund for this work was University of Gondar. The funder has no role in the data collection, analysis, design of the study and interpretation of data for this manuscript.