AUTHOR=Sagnier Sharmila , Renou Pauline , Olindo Stéphane , Debruxelles Sabrina , Poli Mathilde , Rouanet François , Munsch Fanny , Tourdias Thomas , Sibon Igor
TITLE=Gait Change Is Associated with Cognitive Outcome after an Acute Ischemic Stroke
JOURNAL=Frontiers in Aging Neuroscience
VOLUME=9
YEAR=2017
URL=https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2017.00153
DOI=10.3389/fnagi.2017.00153
ISSN=1663-4365
ABSTRACT=Background: Cognition and gait have often been studied separately after stroke whereas it has been suggested that these two domains could interact through a cognitive-motor interference.
Objective: To evaluate the influence of gait changes on cognitive outcome after an ischemic stroke (IS).
Methods: We conducted a prospective and monocentric study including patients admitted for an acute supratentorial IS with a National Institute of Health Stroke Score ≤ 15. Cognition, gait and motor disability were evaluated at baseline, 3 months and 1 year post-stroke, using the Montreal Cognitive Assessment (MoCA), the 10-m walking test (10-MWT) and the Fugl-Meyer motor assessment (FMMA). The effect of changes in 10-MWT over the year of follow-up on MoCA changes was estimated using a generalized linear mixed model with FMMA, age and gender as covariates.
Results: Two hundred and Twelve patients were included (71% male, age 64 ± 13 years old). 10-MWT improved from baseline to 1 year (p < 0.001), as did MoCA (p < 0.001) and FMMA (p < 0.001) scores. Ninety-nine patients (47%) had a MoCA <26 at 1 year. Changes in 10-MWT were independently associated with changes in MoCA (β = −0.2, 95% CI −0.24 to −0.07, Bonferroni-corrected p-value = 0.002). Analyses of MoCA sub-scores suggested that changes in gait performance was associated with changes in executive functions and recall.
Conclusion: Gait performance is associated with cognitive outcome after a mild to moderate IS, suggesting that they should be managed together to improve post-stroke independence.