Résumé

Background: Stroke is a major cause of long-term disability, often accompanied by neurocognitive and executive function impairments. These sequelae significantly affect patients' quality of life, functional independence, and social reintegration. Despite their importance, little data is available on post-stroke cognitive impairment and its predictors in sub-Saharan Africa. Objective: To determine the prevalence and predictors of neurocognitive disorders in the post-acute phase of stroke. Methodology: We conducted a cross-sectional case control study study over nine months among stroke survivors (stroke+) attending outpatient neurology consultations at Laquintinie Hospital in Douala, Cameroon. These patients were matched for age, sex, and comorbidities with controls who had never experienced a stroke (stroke−). Participants with a history of psychiatric illness or prior cognitive impairment were excluded. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). Data were analyzed using SPSS v20.0. Results: A total of 223 participants were included (122 stroke+ and 101 stroke−). The mean age was 58.1 ± 10.4 years in the stroke+ group and 56.5 ± 10.3 years in the stroke− group (p > 0.05), with a male-to-female ratio of 1.1. The prevalence of neurocognitive disorders (NCD) was 28% in stroke+ patients versus 8.5% in controls (p < 0.001). Multivariate analysis identified age > 65 years (p < 0.001), alcohol use (p = 0.001), low educational level (p = 0.001), hemorrhagic stroke (p = 0.003), and NIHSS > 5 (p = 0.002) as independent predictors. Conclusion: Stroke survivors are four times more likely to develop neurocognitive disorders compared to individuals without stroke. One in three stroke patients presents cognitive impairment, and nearly 40% exhibit executive dysfunction. Early identification of predictive factors may help improve rehabilitation strategies and long-term outcomes.

Mot-clés :

Stroke, Neurocognitive Disorders, Predictors, Sub-Saharan Africa