Due to copyright reasons, an electronic copy of the thesis must be ordered from the faculty. In order for the faculty to have time to process the order, it must be received by the faculty no later than 2 days prior to the public defence. Orders received later than 2 days before the defence will not be processed. Inquiries regarding the thesis after the public defence must be addressed to the candidate.
Trial Lecture – time and place
See Trial Lecture.
- First opponent: Professor Peter Langhorne, University of Glasgow, Scotland
- Second opponent: Professor Katharina Stibrant Sunnerhagen, The Sahlgrenska Academy, Sweden
- Third member and chair of the evaluation committee: Professor II Eirik Helseth, University of Oslo
Chair of the Defence
Professor Emeritus Knut Engedal, University of Oslo
Consultant, MD, PhD Hege Ihle-Hansen, Oslo University Hospital
In recent decades, awareness of cognitive impairments after stroke has grown, and research has shown that approximately two-thirds of all stroke survivors experience cognitive challenges post-stroke. To further illuminate the trend, the Norwegian Cognitive Impairment After Stroke (Nor-COAST) study recruited 815 stroke survivors and followed them for 3 years while conducting different cognitive and physical assessments. This thesis is a product of a sub-study of the Nor-COAST study called the EARLY study, the overall aim of which was to define, detect and predict cognitive impairment after stroke.
Post-stroke cognitive impairment were diagnosed 3 months post-stroke by three different diagnostic approaches. Ragnhild Munthe-Kaas and colleagues found that the prevalence of mild and major cognitive impairment after stroke varied depending on diagnostic approach. Overall agreement was better between the different methods for identification of dementia than for mild cognitive impairment.
Further, we explored the accuracy of MoCA, a short screening test for cognition, for diagnosing cognitive impairment after stroke, with a comprehensive cognitive test battery according to DSM-5 criteria as a reference. We found that MoCA had good accuracy for identifying cognitive impairment 3 months after a stroke and that a cut-off of less than 26 between normal cognition and any cognitive impairment balanced sensitivity and specificity.
Last, we wanted to identify possible connections between frailty and post-stroke cognitive impairment. We adapted the Frailty Index for pre-stroke medical status and analysed participants with Frailty Index scores and a completed cognitive test battery at 3 months. The results showed that frailty is a strong predictor for cognitive impairment after stroke. We also demonstrated that Frailty Index is a stronger predictor for cognitive impairment after stroke compared to the widely used function scale in stroke medicine, modified Rankin Scale.
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