Principal published studies of the prevalence of PSCI.

<p>BDS, Blessed Dementia Scale; HDRS, Hamilton Depression Rating Scale; MMSE, Mini-Mental State Examination; MoCA, Montreal Cognitive Assessment; TIA, transient ischemic attack; PSCI, post-stroke cognitive impairment; VDB, Vascular Dementia Battery;-, No reported.</p><p>Principal published studies of the prevalence of PSCI.</p

Location of the study area.

<p>In the 2 areas studied, stroke, hypertension, coronary artery disease, and diabetes are classified as community-managed chronic diseases [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0122864#pone.0122864.ref018" target="_blank">18</a>–<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0122864#pone.0122864.ref019" target="_blank">19</a>]. This means patients will get higher reimbursement ratio in Community Health Service Centers (CHSCs) (90% to 100% in CHSCs VS 40% in other hospitals) and more convenience for referral to the senior hospitals. So, stroke survivors are obligated to register in CHSCs for primary rehabilitation care. Meanwhile, CHSCs are responsible to report patients with the four chronic diseases to the surveillance center, usually the Center for Disease Control (CDC). We used the registered information in CHSCs and an adequate number of cases was available from the CHSCs in the 2 selected areas.</p

Flow chart illustrating the diagnosis of PSCI.

<p>Flow chart illustrating the diagnosis of PSCI.</p

Prevalence of Post-Stroke Cognitive Impairment in China: A Community-Based, Cross-Sectional Study

<div><p>International hospital-based studies have indicated a high risk of cognitive impairment after stroke, evidence from community-based studies in China is scarce. To determine the prevalence of post-stroke cognitive impairment (PSCI) and its subtypes in stroke survivors residing in selected rural and urban Chinese communities, we conducted a community-based, cross-sectional study in 599 patients accounting for 48% of all stroke survivors registered in the 4 communities, who had suffered confirmed strokes and had undergone cognitive assessments via the Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), and Hachinski Ischemia Scale (HIS). Detection of PSCI was based on scores in these neuropsychological scales. Factors potentially impacting on occurrence of PSCI were explored by comparing demographic characteristics, stroke features, and cardiovascular risk factors between patients with and without PSCI. The overall prevalence of PSCI was 80.97% (95%CI: 77.82%-84.11%), while that of non-dementia PSCI (PSCI-ND) and post-stroke vascular dementia (PSD) was 48.91% (95%CI: 44.91%-52.92%) and 32.05% (95%CI: 28.32%-35.79%), respectively. Prior stroke and complications during the acute phase were independent risk factors for PSCI. The risk of recurrent stroke survivors having PSCI was 2.7 times higher than for first-episode survivors, and it was 3 times higher for those with complications during the acute phase than for those without. The higher prevalence of PSCI in this study compared with previous Chinese studies was possibly due to the combined effects of including rural stroke survivors, a longer period from stroke onset, and different assessment methods. There is an urgent need to recognize and prevent PSCI in stroke patients, especially those with recurrent stroke and complications during the acute phase.</p></div