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Karakteristik Gangguan Neurokognitif Pasien Pasca Stroke di RSUP

Sanglah Denpasar Periode 1 Maret-31 Mei 2017


Ida Bagus Kade Satyagraha,* Ketut Widyastuti,** A.A.A. Putri
Laksmidewi**

* Peserta PPDS Ilmu Penyakit Saraf FK UNUD/RSUP Sanglah Denpasar


** Staf Pengajar Ilmu Penyakit Saraf FK UNUD/RSUP Sanglah Denpasar

Abstrak
Latar Belakang: Gangguan neurokognitif merupakan komplikasi stroke yang
sering terjadi namun tidak terdiagnosis dan tidak mendapatkan penanganan
adekuat sehingga dapat menghambat rehabilitasi, meningkatkan morbiditas,
dan mortalitas pasien. Depresi merupakan salah satu penyebab gangguan
neurokognitif pada pasien pasca stroke.
Tujuan: Mengetahui karakteristik gangguan neurokognitif pasca stroke
berdasarkan demografis, klinis, dan gejala depresi di RSUP Sanglah Denpasar.
Metode: Penelitian deskriptif potong lintang terhadap 70 pasien pasca stroke
untuk menilai karakteristik gangguan neurokognitif menggunakan Montreal
Cognitive Assessment Indonesian Version (MoCA-Ina) dan Geriatric
Depression Scale (GDS).
Hasil: Gangguan neurokognitif didapat pada 40 pasien (57,1%) dengan
visuospasial/eksekutif dan memori tunda sebagai domain yang paling banyak
terganggu (95%). Gangguan neurokognitif lebih sering dijumpai pada dewasa
madya (55%), jenis kelamin laki-laki (62,5%), pendidikan rendah (42,5%),
tidak bekerja (65%), dan menikah (95%). Berdasarkan klinis, gangguan
neurokognitif lebih sering dijumpai pada stroke iskemik (69,2%), serangan
stroke pertama kali (87,2%), waktu antara onset stroke dan pemeriksaan
neurokognitif <2 bulan (61,5%), mengenai hemisfer kanan (51,3%), lesi tunggal
(87,2%), dan memiliki riwayat hipertensi (65%). Gejala depresi didapatkan
pada 57,5% kelompok gangguan kognitif dan sebagian besar merupakan depresi
ringan (47,8%).
Kesimpulan: Gangguan neurokognitif pasca stroke paling banyak didapatkan
pada stroke iskemik, serangan stroke pertama kali, waktu antara onset stroke
dan pemeriksaan <2 bulan, mengenai hemisfer kanan, lesi tunggal, dan
memiliki riwayat hipertensi. Sebagian besar kelompok gangguan neurokognitif
mengalami depresi terutama depresi ringan.
Kata Kunci: Gangguan kognitif, depresi pasca stroke, MoCA-Ina, GDS.
The Characteristics of Post-stroke Neurocognitive Impairments in
Sanglah General Hospital From 1 March to 31 May 2017
Ida Bagus Kade Satyagraha,* Ketut Widyastuti,** A.A.A. Putri
Laksmidewi**

* Resident of Neurology Department of Sanglah General Hospital/Udayana


Medical Faculty
** Lecturer of Neurology Department of Sanglah General Hospital/Udayana
Medical Faculty

Abstract
Introduction: Neurocognitive impairments were frequent complication of
stroke which were underdiagnosed and inadequately treated so it could impair
rehabilitation, increase morbidity, and mortality of stroke patients. Depression
was one of the causes of post-stroke neurocognitive impairments.
Aims: To describe the characteristics of post-stroke neurocognitive
impairments based on demographic, clinical, and depressive symptoms in
Sanglah General Hospital Denpasar.
Methods: Descriptively cross sectional study was conducted on 70 post-stroke
patients to evaluate the characteristics of neurocognitive impairment using
Montreal Cognitive Assessment Indonesian Version (MoCA-Ina) and Geriatric
Depression Scale (GDS).
Results: Neurocognitive impairments were identified in 40 patients (57,1%)
with visuospatial/executive and delayed memory as the most frequent abnormal
findings (95%). It is more frequently identified in middle age adults (55%), male
gender (62,5%), low educated (42,5%), unemployed (65%), and married (95%)
patients. Based on clinical factors, it is more frequently identified in ischaemic
stroke (69,2%), first time stroke (87,2%), time between stroke onset and
examination in less than 2 month (61,5%), right hemisphere involvement
(51,3%), single lesion (87,2%), and had history of hypertension (65%).
Depressive symptoms were identified in 57,5% cognitively impaired patients
with mild depression as the most frequent findings (47,8%).
Conclusions: Post-stroke neurocognitive impairments more frequently
identified in ischaemic stroke, first time stroke, with time between stroke onset
and examination in less than 2 month, involving right hemisphere, single lesion,
and had history of hypertension. Depressive symptoms more frequently
identified in cognitively impaired patients and mostly had mild depressive
symptoms.
Keywords: Cognitive impairment, post-stroke depression, MoCA-Ina, GDS.