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Cognitive recovery trajectories 3 months following stroke in Mexican American and non-Hispanic white adults

  • Emily M. Briceño
    Correspondence
    Corresponding author.
    Affiliations
    Department of Physical Medicine & Rehabilitation, University of Michigan Medical School, 325 E. Eisenhower Blvd, Ann Arbor, MI 48108, United States
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  • Liming Dong
    Affiliations
    Department of Epidemiology, University of Michigan School of Public Health and Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, 325 E. Eisenhower Blvd, Ann Arbor, MI 48108, United States
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  • Deborah A. Levine
    Affiliations
    Departments of Internal Medicine and Neurology and Cognitive Health Services Research Program, University of Michigan Medical School, 325 E. Eisenhower Blvd, Ann Arbor, MI 48108, United States
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  • Madeline Kwicklis
    Affiliations
    Department of Epidemiology, University of Michigan School of Public Health, 325 E. Eisenhower Blvd, Ann Arbor, MI 48108, United States
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  • Lynda D. Lisabeth
    Affiliations
    Department of Epidemiology and Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Department of Neurology and Stroke Program, University of Michigan Medical School, 325 E. Eisenhower Blvd, Ann Arbor, MI 48108, United States
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  • Lewis B. Morgenstern
    Affiliations
    Department of Neurology and Stroke Program, University of Michigan Medical School; Department of Epidemiology and Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, 325 E. Eisenhower Blvd, Ann Arbor, MI 48108, United States
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      Highlights

      • Mexican Americans showed lower cognitive performance compared to non-Hispanic white adults at post-stroke baseline and 3 months following stroke.
      • Cognitive trajectories from 0-3 months following stroke did not differ between Mexican Americans and non-Hispanic white adults.
      • Further research is needed to identify factors contributing to ethnic disparities in cognitive outcomes after stroke.

      Abstract

      Objectives

      We examined whether cognitive trajectories from 0-3 months after stroke differ between Mexican Americans (MAs) and non-Hispanic white (NHW) adults.

      Materials and Methods

      The sample included 701 participants with ischemic stroke (62% MA; 38% NHW) from the population-based stroke surveillance study, the Brain Attack Surveillance in Corpus Christi (BASIC) Project, between 2008-2013. The outcome was the modified Mini Mental State Examination (3MSE, range 0-100 lower scores worse). Linear mixed effects models were utilized to examine the association between ethnicity and cognitive trajectories from 0-3 months following stroke, adjusting for confounders.

      Results

      MAs were younger, had lower educational attainment, and fewer had health insurance than NHWs (all p< 0.01). A smaller proportion of MAs were rated by informants as exhibiting pre-stroke cognitive decline than NHW (p < .0.05). After accounting for confounders, MAs demonstrated lower cognitive performance at post-stroke baseline and at 3-months following stroke (-2.00; 95% CI =-3.92, -0.07). Cognitive trajectories from 0-3 months following stroke were indicative of modest cognitive recovery (increase of 0.034/day, 95% CI =0.030-0.036) and did not differ between MAs and NHWs (p = 0.68).

      Conclusion

      We found no evidence that cognitive trajectories in the first three months following stroke differed between MAs and NHWs. MAs demonstrated lower cognitive performance shortly after stroke and at three months following stroke compared to NHWs. Further research is needed to identify factors contributing to ethnic disparities in cognitive outcomes after stroke.

      Keywords

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