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BACKGROUND@#Insufficient cerebral perfusion is suggested to play a role in the development of Alzheimer disease (AD). However, there is a lack of direct evidence indicating whether hypoperfusion causes or aggravates AD pathology. We investigated the effect of chronic cerebral hypoperfusion on AD-related pathology in humans.@*METHODS@#We enrolled a group of cognitively normal patients (median age: 64 years) with unilateral chronic cerebral hypoperfusion. Regions of interest with the most pronounced hypoperfusion changes were chosen in the hypoperfused region and were then mirrored in the contralateral hemisphere to create a control region with normal perfusion. 11C-Pittsburgh compound-positron emission tomography standard uptake ratios and brain atrophy indices were calculated from the computed tomography images of each patient.@*RESULTS@#The median age of the 10 participants, consisting of 4 males and 6 females, was 64 years (47-76 years). We found that there were no differences in standard uptake ratios of the cortex (volume of interest [VOI]: P = 0.721, region of interest [ROI]: P = 0.241) and grey/white ratio (VOI: P = 0.333, ROI: P = 0.445) and brain atrophy indices (Bicaudate, Bifrontal, Evans, Cella, Cella media, and Ventricular index, P > 0.05) between the hypoperfused regions and contralateral normally perfused regions in patients with unilateral chronic cerebral hypoperfusion.@*CONCLUSION@#Our findings suggest that chronic hypoperfusion due to large vessel stenosis may not directly induce cerebral β-amyloid deposition and neurodegeneration in humans.
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Aged , Female , Humans , Male , Middle Aged , Alzheimer Disease/pathology , Amyloid beta-Peptides/metabolism , Arteries , Atrophy , Brain/metabolism , Cerebral Cortex/metabolism , Cerebrovascular Circulation , Constriction, Pathologic/pathology , Magnetic Resonance Imaging/methods , Positron-Emission Tomography/methodsABSTRACT
Alzheimer′s disease (AD), the most common neurodegenerative disease, is a major challenge in China and all the world. However, the pathogenesis of AD remains unclear, and no disease-modifying therapies are available to prevent or treat the disease. Amyloid-beta (Aβ) and hyperphosphorylated tau protein are key pathological molecules of AD. A series of clinical trials targeting Aβ, tau protein and neuroinflammation have been carried out in the past 20 years, but none of them have been successful in attenuating the cognitive decline so far. This paper discusses the challenges of the current clinical trials of AD and proposes future directions for the research of AD prevention and treatment.
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Objective:To assess the β-amyloid (Aβ) deposition of voxel-based PET imaging in Alzheimer′s disease (AD) and its relationships with blood biomarkers (Aβ).Methods:From January 2015 to December 2018, a total of 23 AD patients (9 males, 14 females, age (68.5±9.0) years; duration: (40.9±23.3) months; 8 mild patients, 15 moderate or severe patients) who underwent Aβ PET and with positive imaging results in Daping Hospital, Army Medical University were retrospectively enrolled. The information of Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR) were collected. Blood level of Aβ42, Aβ40 were measured. Differences of those metrics including Aβ42/Aβ40 between mild and moderate or severe patients were compared. For all 11C-Pittsburgh compound B (PIB) PET images, voxel-based one-sample independent t test analyses were performed. Voxel-based two-sample independent t test analyses were also performed between mild and moderate or severe patients. The voxel-based Pearson correlation analyses were run to assess the associations between blood metrics and Aβ deposition of 11C-PIB PET. Results:Comparing with mild patients, moderate or severe patients had lower MMSE (9.67±4.37 vs 17.13±2.80; t=4.349, P<0.001) and longer duration ((48.8±23.8) vs (26.0±13.5) months; t=-2.489, P<0.05). On voxel-wise analysis, amyloid PET illustrated brain Aβ deposition in bilateral frontal, right temporal, right occipital and posterior cingulate regions ( t values: 0.44-0.67, all P<0.001). Within AD, Aβ42/Aβ40 ( r values: from -0.62 to -0.41, 0.41-0.66, all P<0.05) were associated with amyloid PET, but not associated with Aβ42 ( r values: from -0.33 to 0, all P>0.05) or Aβ40 ( r values: from -0.41 to 0, all P>0.05). Conclusions:Based on voxel-wise analysis, 11C-PIB PET has comparable value for brain Aβ deposition. Aβ42/Aβ40 has the potential to predict brain Aβ deposition.
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Objective To investigate the effect of α7nAchR gene 713T>C mutation on the cognitive function and Aβ expression in Alzheimer′s disease(AD)mice.Methods Twenty APPSwe transgenic APPa7KO mice(6 months old,α7nAchR gene knockout)were divided into the mutation type group and wild type group according to the random number table method,10 cases in each group.The mutation type and wild type of AVV-α7nAchR cDNA were respectively injected by lateral ventricle,once per month,for 6 times.The change of cognitive function in mice was examined by Morris water maze.The ELISA method was used to detect Aβ 40 and Aβ 42 expression levels.The Aβ plaque deposit situation was detected by the immunochemical method.Results Compared with the mice in the wild type group,the escape latency and the time of first time to find the platform of the mice in the mutation type group were significantly extended,while Hippocampal Aβ40 and Aβ42 expression levels were significantly increased,the difference was statistically significant(P＜0.05).Conclusion α7nAchR gene 713T>C mutation aggravates the cognitive function impairments in AD mice and hippocampal neuron Aβ expression level.
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Objective To evaluate the effectiveness of internet-based cognitive behavior therapy (CBT-I) on blood pressure in patients with hypertension comorbid with insomnia.Methods One hundred and six patients met the JNC-8 diagnostic criteria for hypertension and DSM-5 diagnostic criteria for insomnia were selected,and randomly assigned to CBT-I group (n=53) and regular treatment group (n=53).All the patients accepted relevant treatment for 8 consecutive weeks.Changes of systolic blood pressure (SBP),diastolic blood pressure (DBP),the sleep parameters and the anxiety and depression levels were observed between baseline and 8 weeks of follow-up.Results Compared with pre-treatment,SBP and DBP decreased significantly in both CBT-I group and regular treatment group (P＜0.01),the decrease was more significant in CBT-I group than in regular treatment group (P＜0.01).The sleep latency,sleep efficiency,bed time and rating anxiety scale were improved more significantly in CBT-I group than in regular treatment group (44.49 ± 22.75min vs.55.50 ± 34.96min;72.31％ ± 9.15％ vs.57.70％ ± 11.53％;302.65 ± 43.76min vs.262.70 ± 50.64min and 17.14 ± 6.45 vs.21.02 ± 6.64,respectively),the differences were of statistical significance (P＜0.05).In addition,no significant difference was found in the level of depression between CBT-I group and regular treatment group.Conclusion CBT-I can effectively shorten sleep latency,improve sleep efficiency,extend bed time and improve anxiety,meanwhile effectively lower the blood pressure of patients with hypertension comorbid with insomnia by optimizing sleep quality.
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Objective To investigate the imaging changeof cerebral ischemireperfusion injury (CIRI) afteinterventional therapy in acute middle cerebral artery occlusion .Method32 patientwith acute middle cerebral artery occlusion in ouhospital from January 2013 to Novembe2014 were selected .16 casewere performed the recanalization therapy aftearterial thrombolysiand/omechanical thrombectomy(recanalization group) and 16 casewere notreated by thrombolytitherapy (non-recanalization group) .The differenceof brain imaging changes(onse,on 3 ,7 d afteonset) were analyzed and compared between the two group. ResultThe proportion of lateral ventricle compression degree and the shifdegree of brain midline on 3 d afteonsein the reca-nalization group were greatethan those in the non-recanalization group ,the differencebetween the two groupwere statistically significant[0 .50 ± 0 .11 v.0 .58 ± 0 .10 ,0 .57(0 .18 ,0 .83)cm v.0 .22(0 ,0 .57)cm ,P＜0 .05] ,while which on 7 d of onsein the recanalization group were lesthan those in the non-recanalization group[0 .80 ± 0 .11 v.0 .55 ± 0 .12 ,0(0 ,0 .13) v.0 .46(0 , 0 .88)cm ,P＜0 .055] .Conclusion Although the interventional therapy ian importanmeasure foearly treatmenof ischemistroke ,buiaggravatethe early brain edem,therefore CIRI induced by the interventional therapy should be paid more attention to.
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Objective To investigate the fear and attitude of the common people to some threatening diseases .Methods Accord-ing to the age and sex structure of the whole nation ,500 common people were randomly enrolled in the public places of Chongqing main urban area .Firstly ,the respondents were asked to name three diseases they feared most .Then their fear degrees to eight im-portant diseases were performed the questionnaire survey .Results The top ten diseases that common people fear most by their own words were cancer ,AIDS ,heart disease ,hypertension ,stroke ,leukemia ,chronic liver diseases ,diabetes mellitus ,dementia and de-pression successively .Meanwhile ,their fear to the eight important diseases ,which was determined by the ratio of people who did fear to all ,were cancer(94 .2% ) ,traffic accidents(89 .2% ) ,heart disease(85 .0% ) ,AIDS(79 .4% ) ,tuberculosis(76 .8% ) ,hepatitis B(76 .6% ) ,Alzheimer′s disease(73 .4% ) and depression(69 .0% ) .Further analysis showed that such fear was significantly influ-enced by age ,sex and education level .Conclusion The knowledge and perception of common people about certain diseases is one-si-ded ,and their health awareness should be improved .
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Objective To compare the serum levels of interleukin(IL)‐1β,IL‐6 ,tumor necrosis factor alpha(TNF‐α) and inter‐feron gamma(IFN‐γ) in patients with Parkinson′s disease(PD) and healthy controls .To analyze the correlations of serum inflamma‐tory factors with disease duration and severity .Methods Peripheral blood samples were collected from 56 PD patients and 120 healthy controls .Serum levels of IL‐1β,IL‐6 ,TNF‐αand IFN‐γwere measured using highly sensitive enzyme linked immunosorbent assay(ELISA) kits .Results Serum levels of IL‐1β,IL‐6 ,TNF‐α were significantly higher in PD patients than in healthy controls (all P0 .05) .Conclusion Our results indicate that serum inflammatory factors are altered in PD patients .However ,serum inflammatory factors were not correlated with disease duration and severity .
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Objective To provide scientific basis for developing mental interventions for the wounded in major disasters by assessing the mental health status and the mental intervention effect among the Wenchuan earthquake survivors transferred to Chongqing.Methods A total of 389 transferred wounded survivors were examined by using questionnaires including general information questionnaire,Psychological Health Self-rating Questionnaire (PHSQ),Symptom Checklist 90 (SCL-90),Perceived Social Support Scale (PSSS) and Coping Styles Questionnaire (CSQ).According to PHSQ,the wounded were divided into control group and stress group.Then,the stress group was given mental intervention and taken the second mental evaluation one month later.Results Acute stress disorder (ASD) rate (30.08％) was remarkably observed in these transferred wounded,who were subsequently administered a set of mental intervention.The wounded whose PHSQ mark ≥8 were defined as the stress group (Group A) and the others as the control group ( Group B).Compared with Group B,Group A had higher scores in depression ( P ＜ 0.01 ),anxiety ( P ＜ 0.01 ) and consternation ( P ＜ 0.01 ),and lower scores in PSSS (P ＜0.01 ).Group A inclined to negative coping styles mainly including shrink back (P ＜ 0.01 ) and fantasy (P ＜0.01 ),while Group B inclined to coping styles mainly including rationalization and help.The PSSS score in Group A was significant lower than that in Group B (P ＜ 0.01 ).The scores in PHSQ,SCL-90 (anxiety and consternation),CSQ and PSSS were significantly improved after the mental intervention in Group A.Conclusions The incidence of ASD is high in the transferred wounded survivors and is mainly related with mental stress,such as emotional symptoms,negative coping styles and low perception of social support.Early mental interventions will help improve the psychological status of the transferred wounded.
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Objective To investigate the characteristics of the mental health and the change of serum copeptin,cortisol and aldosterone levels of the soldiers in field army under military exercises stress.Methods A total of 294 soldiers were evaluated with the psychological stress self evaluation test (PSET) before the exercises and the soldiers whose PSET score were T ＜ 70 had to accept the survey with the general information questionnaire before the exercises, and another two questionnaires including PSET and Symptom Checklist 90 (SCL-90) after the exercises, the higher stress group and lower stress group were defined according to the PSET score, T≥70 and T ＜ 70 respectively.Meanwhile, we draw the venous blood of them in order to detect the serum concentration of copeptin,cortisol and aldosterone before and after the military exercise.Results ( 1 ) After the survey of PSET before the exercises,263 soldiers were determined to be the final research objects.According to the score of PSET after the exercises, 104 soldiers(39.5% ) were considered as the higher stress group,and the symptoms mainly included anxiety,hostility and poor sleep and appetite.(2) Compared with the lower stress group,the higher stress group were younger(21.51 ± 3.13 vs 24.09 ± 4.16, P ＜ 0.01 ), higher at the proportion of soldiers ( 68.27% vs 54.09%, P＜0.01 ) and lower at the proportion of soldiers who have experiences of military exercises(37.50% vs 57.23%, P＜0.01 ).(3) Compared with the lower stress group,the higher stress group had higher score in EPQN ( 10.43 ± 1.78 vs 8.77 ± 1.67, P ＜ 0.01 ).(4) The serum levels of copeptin ( P ＜ 0.01 ), cortisol ( P ＜ 0.01 )and aldosterone( P＜0.01 ) have increased after the military exercise.Compared with the lower stress group, the higher stress group have higher serum copeptin level ( 11.36 ± 2.21 vs 9.43 ± 2.34, P ＜ 0.01 ) after the exercises.( 5 ) The relationship between PSET score and the copeptin level after exercise can be expressed as a formula: PSET score = 27.909 + 3.669X ( X: copeptin level after exercise), and 11.472 pmol/L was considered as the threshold value.Conclusion As a strong stress agent, military exercises may cause obvious physiological changes and has notable effect on related hormones.The change of serum copeptin level can be used as a sensitive indicator to determine the degree of stress.
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The application of cerebrovascular intervention brings the diagnosis and treatment of cerebrovascular disease into a brand-new domain. Many neurological physicians have become physicians of cerebrovascular intervention by training. In the big teaching hospitals carrying out cerebrovascular intervention, advanced physicians are the hard strength in the lot of cerebrovascular intervention. The training aiming at cerebrovascular intervention and comprehensive abilities affects both the training results and the therapeutic results of cerebrovascular intervention. Therefore, it is an important issue to explore how to consummate and standard the training methods of advanced physicians studying cerebrovascular intervention.
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BACKGROUND: In subjects with different inflammatory and autoimmune diseases, soluble vascular cell adhesion molecule-1 (sVCAM-1) in sera increases, and its change may become an important monitoring index of immunological function, but its change rule has been unclear in acute cerebral infarction.OBJECTIVE: To observe the change of sVCAM-1 in sera of subjects with cerebral infarction and its clinical significance, and compare between the subjects with cerebral hemorrhage and normal population.DESIGN: A case controlled analysis.SETTING: Second Department of Brain, Research Institute of Surgery,Daping Hospital, Third Military Medical University of Chinese PLA.PARTICIPANTS: A total of 132 inpatients were selected from Second Department of Brain, Research Institute of Surgery, Daping Hospital, Third Military Medical University of Chinese PLA between May 2002 and April 2004. Among them, 89 subjects with cerebral infarction were classified into large infarction group (n=25,＞ 10 cm3), medium infarction group (n=31,4-10 cm3) and small infarction group (n=33, ＜ 4 cm3) respectively according to the size of infarct focus. There were 43 subjects in cerebral hemorrhage group, and 30 healthy persons were as normal control group.METHODS: Blood samples were isolated from subjects with cerebral infarction at hour 24, days 3, 7 and 14 after onset of the disease, while the blood samples were extracted from subjects with cerebral hemorrhage at hour24 and day 14 after the onset of the disease. 4 mL venous blood was obtained from the three groups. The serum concentration of sVCAM-1 was determined with double antibody sandwich method (DASM) in all the examinees.MAIN OUTCOME MEASURES: ①Dynamic change of the serum concentration of sVCAM-1 in the course of acute cerebral infarction, and compared with the other two groups. ②Comparison of the serum concentration of sVCAM-1 in different size of infarct focus. ③Change of the serum concentration of sVCAM-1 in acute cerebral infarction subjects complicated with infection.RESULTS: A total of 162 subjects were involved in the result analysis. ①The serum concentration of sVCAM-1 at the 24th hour after cerebral infarction was significantly higher in subjects with cerebral infarction than in subjects with cerebral hemorrhage group and normal control group [(1 184.5±68.3) ,(693.9±41.7), (576.1±39.8) μg/L,P＜0.01].Serum sVCAM-1 in the cerebral infarction subjects increased from the 24th hour to the 7th day after infarction gradually, while from the 7th day to the 14th day decreased gradually. However, the serum sVCAM-1 in the cerebral infarction subjects at day 14 was still markedly higher than that in the cerebral hemorrhage group and the normal control group (P ＜ 0.01 ). ②The serum concentration of sVCAM-1 was significantly higher in the large cerebral infarction group as compared with medium and small cerebral infarction groups [(1 217.4±59.3) ,(1 132.6±51.9) ,(983.7±54.2) μg/L,P ＜ 0.01]. ③The serum concentration of sVCAM-1 was significantly higher at days 3, 7and 14 in cerebral infarction subjects complicated with infection than in subjects without infection (P ＜ 0.01 ).CONCLUSION: The sVCAM-1 participates pathological change process of cerebral infarction, which can be regarded as monitoring index of cerebral infarction change. To block its production and expression can provide a new approach for improving the prognosis of cerebral infarction.
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BACKGROUND:With the trend of population aging,the morbidity of cognitive dysfunction has been gradually increased.People start to pay attention to the impact of smoking to cognitive dysfunction. OBJECTIVE:To investigate the effects of smoking on cognitive dysfunction in elder people,and explore the possibility of intervention. DESIGN:Randomized cluster sampling. SETTING:Neurology Department of a hospital. PARTICIPANTS:A total of 3 012 old people aged above 60 year were selected from two resident committees by drawing from Gaoxin district,Yubei district and Yuzhong district of Chongqing in which there were 1 668 males and 1 344 females. METHODS:Mini mental state examinate(MMSE) was used to assess cognitive function.t test and Logisitc regression were used to analyze the information. RESULTS:MMSE assessment was conducted to 3 012 people,the total smoking rate was 35% .The abnormality rate of cognitive function in aged people of Chongqing was 11.95% .Among smoking population,11.8% of the currently smoking people and 4.5% of previously smoking people suffered from the cognitive dysfunction while 5.3% of the non smoking people got cognitive dysfunction. CONCLUSION:Smoking is closely correlated with cognitive dysfunction(χ 2=6.59,P=0.047) and education background, age, occupation and sex are the influencing factors of cognitive dysfunction.Current smoking people get higher risk to suffer cognitive dysfunction(RR=2.33,95% CI=1.37- 5.82).Smoking is an important risk factor for cognitive dysfunction in aged people so that it will be an effective strategy for aged people to reduce the incidence of cognitive dysfunction by quitting smoking.
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BACKGROUND: Pro-inflammatory cytokines can promote the expression nof intercellular adhesion molecule-1 (ICAM-1), and the adhesion of white cells to intravascular endothelium, thereby involving in the developing ischemic stroke.OBJECTIVE: To investigate the prognostic value of soluble intercellular adhesion molecule-1 (sICAM-1) and its relative factors in the developing ischemic stroke.DESIGN: Randomized controlled study based on patients.SETTING: Department of neurology, the field surgery research institute in a military hospital of Chinese PLA.PARTICIPANTS: Between January 1st and December 31st 2000, total 238patients with ischemic stroke received treatment at the Neurological Department of the Third Affiliated Hospital, the Third Military Medical University of Chinese PLA, including 117 males and 121 females, amongst which 186cases were confirmed of none-developing ischemic stroke and 52 cases developing ischemic stroke.INTERVENTIONS: After hospitalization, patients were subject to daily neurological examination, Canada stroke score(CSS), temperature and white blood cell(WBC) counting, sICAM was examined at 1, 3 and 7 days after hospitalization.correlative factors between developing ischemic stroke and non-developing ischemic stroke at 24 hours 3 days and 7 days after the onset of stroke.RESULTS: Within 24 hours from the onset of stroke, the number of WBC was[(8.4 ± 1.2) × 109 L-1] in developing ischemic stroke group, with blood glucose of[ (45.8 ± 5.1) g/L], fibrinogen of[ (64. 6 ± 5. 1) g/L] and sICAM-1 of[ (261.4 ± 9. 7) μg/L], which were obviously higher than the corresponding[(6.7±1.3) ×109 L-1, (36.2±5.5) g/L, (44.0±6.2) g/L,(223. 1 ± 8.4) μg/L] in non-developing ischemic stroke group, the difference was of statistical significance( t = 2. 368 - 2. 387, P ＜ 0. 01 ) . The results of multiple factor analysis on developing ischemic stroke indicated that serum sICAM-1 was a risk factor independent of higher blood glucose,fibrinogen and CSS, and was obviously correlated with developing ischemic stroke( OR =2.9, 95% CI= 1.4 -6. 3) . There was significant change in sICAM-1, the number of WBC, blood glucose and fibrinogen at 24 hours, 3days and 7 days, as well as the scores for CSS at hospitalization in developing ischemic stroke group, which were significantly different from non-developing ischemic group( t = 2. 345 - 2. 878, P ＜ 0.01 ).CONCLUSION: sICAM-1 was proved obviously correlated with developing ischemic stroke, and can be used as a prognostic factor.
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BACKGROUND: The number of dementia patients ceaselessly increases with the extension of the life expectancy and the ageing of the population; hence the survival rate of patients with post-stroke dementia(PSD) has become an important issue of public health. Although it is generally believed that dementia could shorten human life expectancy, there is rare report regarding the impact of PSD on the survival rate of the patients in developing countries.OBJECTIVE: To investigate the impacts of ischemic dementia on the survival rate of the patients to explore the risk factors that would affect the survival rate of patients after cerebral infarction(CI).DESIGN: A prospective randomized controlled study based on patients.SETTING: The second department of neurology of a field surgery institute in a military university hospital of Chinese PLA.PARTICIPANTS: Totally 619 cases of acute CI including 313 males and 306 females aged between 55 and 85 years old[mean of (70. 3 ±9.5) years old] were selected form the Department of Neurology of the Daping Hospital of the Third Military Medical University of Chinese PLA between 1st May 1998 and 28th December 1999.INTERVENTIONS: Data including human factor, vascular factor and CI characters of 619 cases of ischemic cerebral stroke were collected and they also received neuropsychological test. Dementia was diagnosed in CI patients at admission and 3 months after CI according to DSM-Ⅳ criteria. Two-year follow up was conducted for the analysis of survival rate in PSD patients and survival-correlated predicting factors.and survival rate in CI patientsRESULTS: Totally 146 total patients(23.6% ) were diagnosed as PSD at 3 month after CI, of which 39 cases were pre-stroke dementia and 107 cases were CI-correlated dementia. The survival rate of PSD patients was 49.3%after(19.4 ±8.3) months of follow-up. The survival rate of patients with CI-correlated dementia was 53.7% while the non-dementia patients was 92.0% after(21.3 ± 9.1 ) months of follow-up. There was significant correlation between PSD and survival rate as indicated by multifactor analysis ( RR = 4. 91, 95% CI = 3.85 - 13.49) . The rest predicting factors included age(RR=1. 12, 95% CI=1.06-1.18), BarthelIndex(BI, RR=1.63,95% CI=1.15-2.31), auricular fibrillation(AF, RR=1.47, 95%CI = 1.17 - 1.85) and CI history( RR = 2. 81, 95% CI = 1.53 - 5.16).CONCLUSION: Dementia could reduce the survival rate of CI patients and it could be set as a predicting factor for post-infarction survival rate.
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BACKGROUND: The presence of cognitive impairment following stroke onset strongly indicates poor prognosis of the patients surviving the crisis.Understanding of the incidence of cognitive impairment after ischemic stroke and its confidence interval has practical significance in preventing is occurrence in stroke patients and its differentiation from age-related cognitive impairment.OBJECTIVE: To study the incidence of cognitive impairment in patients with the first onset of ischemic stroke.DESIGN: Single-factor analyses of the cases followed up for 3 months SETTING: Research Institute of Surgery, Daping Hospital, Third Military Medical University of Chinese PLA.PARTICTPANTS: Totally 434 inpatients with acute cerebral infarction [218 male and 216 female, aged 55 to 85 with a mean of (70.3±9.5) years]admitted within 48 hours after the onset in Department of Neurology, Daping Hospital of Third Military Medical University from May 8, 1999 to December 31, 2000. All patients participated in this study voluntarily.METHODS: The general background and clinical data of the patients were collected at the time of admission. A simplified intelligence test was performed both 7 to 10 days of the onset and 3 months after discharge. The scale employed for the test included 20 questions with a total of 30 items divided to test 5 aspects of the patients' cognition, namely orientation ability, memory, calculation ability, memory recall and linguistic ability (1 point was given for a correct answer, and 0 for an wrong one or an answer of "I don't know", with the total score of 30 for all items). A score of the simplified intelligence test less than the score of demarcation (specifically,below 17 for illiterate patients, below 20 for those receiving an education no more than 6 years, and below 24 for those having an education for no less than 7 years) for 3 months after cerebral stroke was regarded as the diagnostic criteria for cognitive impairment.MAIN OUTCOME MEASURES: The incidence of cognitive impairment was recorded 3 months after hospital discharge and single-factor analysis of the scores of simple intelligence test.RESULTS: All the 434 patients were included in result analysis. Totally 161 (37.1%) patients were diagnosed as having cognitive impairment, and 273 (62.9%) had normal cognitive function 3 months after hospital discharge. The mean age of the patients with cognitive impairment was significantly higher than that of the patients with normal cognitive function [(73.0±7.0) years vs (64.5±6.6) years, t=2.626, P ＜ 0.01]. The proportion of patients with cognitive impairment receiving education for no more than 6 years was significantly higher than that among patients with normal cognition (45.3% vs 22.7%, OR=2.823, with 95% confidence interval of 1.855 -4.297), and the score of simple intelligence test was significantly lower in the former patient group (16.3±8.7 vs 23.4±4.2, t=3.352, P ＜ 0.001).CONCLUSION: The incidence of cognitive impairment in this cohort is relatively high. The patients with cognitive impairment following cerebral infarction have obviously older age and poorer education, suggesting significant synergetic effect of age and education with cognitive impairment following cerebral infarction.