Objective: To study neuropsycological profiles and various risk factors of stroke at desert area of India in elderly population (>60 Years).
Design: Community-based survey from different region in India shows a crude prevalence rate for stroke in the range of 200 per 100,000 population. This is the first report of this nature from desert area of the northwestern part of India with special reference to elderly population to study the neuropsycological profile and various risk factors of stroke.
Materials and Methods: This study was conducted on 273 patients of acute stroke admitted in medical wards of PBM hospital Bikaner, a town that is situated in northwest part of India, having latitude of 280 north and longitude of 70,018’s east. It is part of Thar desert area, situated near Indo-Pak border. Out of 273 patients, 130 were above 60 years of age (47%). In all patients detailed history, clinical and neurological examination along with CT scan was done at time of admission. Chi square test (x2) was used to calculate p value. DSM IV criterion was used to diagnose depression in these patients.
Results: Out of 273 patients, 130 were above 60 years of age (47%). Cerebral infraction was noticed in 77 (59.23%) and cerebral hemorrhage was in 53 (40.76%). Most common site of cerebral infarction was various lobes of cerebrum (48.1%), followed by lacunar infraction (15.6%), 15% had normal head CT scan as CT was done within 12 hours in these patients. Basal ganglion was most common site of cerebral hemorrhage (33.7%), followed by lobar bleed (31%), thalamus (13.2%) and Pons (5.3%).
Uncontrolled hypertension was found in 16.8% patients of cerebral infarction and 17.7% of hemorrhage. Systolic, diastolic, and mean BP was significantly higher in patients of hemorrhage in comparison to the patients of infarction. Out of these, systolic and mean blood pressure were having higher statistical significance (p < 0.01) in comparison to diastolic BP (p = 0.015). Smoking was found in 26.8% patients of infarction and 32.3% of hemorrhage. Other risk factors were alcoholism, diabetes, and family and past history of TIA/stroke. Post stroke depression was seen in 46% of cerebral infraction and 18% in hemorrhage at 3 month follow-up. The risk factors for depression was age more than 70 years, living alone after stroke, and severe disability at the onset of stroke
Conclusion: Uncontrolled hypertension and smoking were the most common risk factors in both groups. Cerebral hemorrhage was also more common, as reported elsewhere in this country. It may be due to uncontrolled hypertension. Lobar bleed was second most common site in our study as amyloid angiopathy is supposed to be the most common etiological factor in older patients. Post stroke depression was also common, noticed in 46% of cerebral infraction and 18% in hemorrhage.
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