Objective To compare cognitive profiles and dementia severity among older patients with atrial fibrillation (AF), with and without ischemic stroke (IS), and to evaluate the contribution of vascular burden to global cognitive status. Methods This cross-sectional clinical study included 124 patients aged ≥55 years who were stratified into three groups: AF without IS (n = 50), AF with IS (n = 25), and IS without AF (n = 49). Global cognitive status was assessed using ordinal categories derived from the Mini-Mental State Examination (MMSE). Attention and working memory were additionally evaluated using the Information-Memory-Concentration (IMC) test derived from the Blessed Dementia Scale. Vascular burden was assessed using the Hachinski Ischemic Score (HIS). Group differences were analyzed using appropriate statistical tests, and predictors of worse cognitive status were examined using ordinal logistic regression. Results Patients with combined AF and IS demonstrated a trend toward a less favorable cognitive profile and higher vascular burden compared with patients with AF alone or IS alone. The proportion of female participants differed significantly across groups (p = 0.022), whereas age category and educational level were comparable. In multivariable ordinal logistic regression analysis, higher Hachinski Ischemic Score independently predicted worse global cognitive status (OR 1.79, 95% CI 1.42–2.25; p < 0.001) after adjustment for age, sex, education, and major vascular risk factors. Conclusions Vascular burden plays an important role in cognitive impairment among older patients with atrial fibrillation, particularly when accompanied by ischemic stroke. Incorporating vascular burden assessment into routine clinical evaluation may facilitate earlier recognition and characterization of cognitive impairment in aging populations.

<p>Aim:</p> <p>To assess the impact of cognitive impairments on various domains of quality of life in patients with multiple sclerosis (MS).</p> <p>Methods:</p> <p>This prospective study included 135 MS patients and 50 healthy controls. Participants were divided into three groups: patients with MS for more than one year (n=85), newly diagnosed MS patients (n=50), and healthy individuals (n=50). Neurocognitive assessments included the Mini-Mental State Examination, Wechsler Intelligence Scale, Revised Beta Test, Raven's Coloured Progressive Matrices, Wechsler Memory Scale, Rey-Osterrieth Complex Figure Test, Verbal Fluency Test, Audio-Verbal Learning Test, and the SF-36 Quality of Life Scale.</p> <p>Results:</p> <p>Cognitive impairments were present in 40&ndash;60% of MS patients, with memory dysfunctions being the most prominent (30&ndash;60%). Longer disease duration was associated with poorer visuospatial, visuoconstructive, and attention-related abilities. Patients also showed reduced logical and working memory. Quality of life was significantly lower in MS groups compared to controls, with a notable correlation between cognitive impairment and decreased MMSE scores.</p> <p>Conclusion:</p> <p>Cognitive impairments in MS patients, particularly those affecting memory, executive functioning, and attention, significantly reduce quality of life. Cognitive testing should be considered essential in assessing disease severity and treatment planning.</p> <p style="text-align: justify; text-justify: inter-ideograph; line-height: 150%;"><strong>&nbsp;</strong></p>

Background: The Mini Mental Status Examination (MMSE) and Montreal Cognitive Assessment (MoCA) are the most commonly used scales to detect mild cognitive impairment in population-based epidemiologic studies. The aim of this study was to define which test is more reliable for early diagnosis of vascular dementia – MoCA or MMSE. Material and methodes: This prospective study included 274 patients with acute stroke, both sexes and all age groups. Patients were divided into groups: demented (DP) and non-demented (NDP). Each patient was underwent to a clinical examination and scoring with appropriate scales (MMSE and MoCA). Patients were tested on two times after discharge. Results: Out of the total number of patients, 171 (62.5%) of them were male, and 103 (37.5%) were female (p=0.339). First testing with the MMSE showed that 143 (52%) had mild or moderate dementia. Sixth months after stroke, the number of demented patients increased to 165 (60%). First testing with the MoCA scale showed that 183 (66%) had some degree of dementia, and after the sixth month 191 (69%). The MoCA recorded a greater number of patients with dementia in both, the first and second testing. MoCA is more sensitive than MMSE for detecting patient with vascular dementia 3 and 6 months after stroke (p=0.0004; p=0.01). Conclusion: The MoCA is more sensitive scale than the MMSE for detecting early stages of vascular dementia. It should be used in daily practice more often than the MMSE in order to make a timely diagnosis of the early stage of dementia. Keywords : vascular dementia, MMSE, MoCA

Background: More than 50% of stroke patients have sleep-disordered breathing.Aim: To determine whether the location and type of stroke affect the occurrence of sleep apnea.Patients and methods: We analyzed 110 patients with acute stroke and verified sleep apnea. Acute stroke has been verified either by computerized tomography or magnetic resonance imaging of the brain. Average age was 65.13±9.27 years and it was 59% men. Number of patients without apnea in control group was the same as well as gender distribution, with average age 64±8.69 years.Results: Apnea was verified in 22% patients. The largest number of patients with and without apnea had ischemic stroke 83.6%, while 16.4% of patients had hemorrhagic stroke. Of these, there were 86.2% men and 80% women with ischemic and 13.8% men and 20% women with hemorrhagic stroke. With apnea, the largest number had a lesion in two or more places 51.8%,as well as without apnea 45.45%, but the difference was not statistically significant. According to the acute stroke, the largest number of patients with and without apnea had lesions in the left and right hemispheres 45.4%. There was no statistically significant association between apnea and localization of stroke in the left or in both hemispheres. There is a statistically significant association of AS localization in the right hemisphere with the occurrence of apnea.Conclusion: There is a statistically significant association between the localization of stroke in the right hemisphere and the occurrence of apnea.

Multiple sclerosis (MS) is a chronic, inflammatory, (auto) immune disease of the central nervous system (CNS). The aim of the study was to determine the distribution of cognitive disorders in MS in relation to demographic parameters, degree of clinical disability and depression. The prospective study included 135 subjects with MS in the Clinic of Neurology of the University Clinical Center in Tuzla. The first group consisted of women (101 respondents) and the second of men (34 respondents). Clinical assessment instruments were: Expanded Disability Status Scale Score, Mini Mental Status, Beck Depression Scale, Battery of Cognitive Function Assessment Tests: Wechsler Intelligence Scale, Revised Beta Test, Raven Coloured Progressive Matrix, Wechsler Memory Verification Scale, Audio Memory Test learning, Rey-Osterriecht complex character test, verbal fluency test. There were no significant differences between the mentioned groups in age, level of education, duration of the disease, severity of disease symptoms or in the prevalence of certain forms of MS. Cognitive disorders are present in 40-60 % of subjects with MS. Visuospatial, visuoconstructive, visuoperceptive functions, mnestic functions were most affected in both groups of respondents. There was no difference in the level of depression in relation to sex. Poor results of cognitive parameters in 32.7 % can be considered the cause of high scores of EDSS in female patients and in 29.2 % in patients, which is not statistically significant. The correlation between depression and EDSS is positive but not statistically significant in both sexes. Cognitive disorders are heterogeneous regardless of sex. Cognitive impairment in MS patients is related to impairment of working ability and memory, executive functions and attention. Subjects with a more severe degree of clinical disability had poorer cognitive functions.

Background: More than 50% of stroke patients have sleep-disordered breathing (SDB), mostly in the form of obstructive sleep apnea (OSA). SDB represents both a risk factor and a consequence of stroke. The presence of SDB has been linked with the poorer long-term outcome and increased long-term stroke mortality. About 20 to 40% of stroke patients have sleep-wake disorders (SWD), mostly in form of insomnia, excessive daytime sleepiness/fatigue, or hypersomnia (increased sleep needs). Objective: The aim of this study was to analyze the frequency of risk factors in patients with acute stroke and sleep apnea. Methods: The study included patients without cognitive impairment or with mild cognitive impairment. The diagnosis of apnea syndrome was made on the basis of the Snoring and Apnea Syndrome Questionnaire, the Epworth Sleep Scale, the Berlin Questionnaire, the Stanford Sleepiness Scale, and the General Sleep Questionnaire. The severity of stroke was assessed by the National Institutes of Health Stroke Scale and the Rankin Disability Scale. Patients with a Glasgow score <8 on the day of neuropsychiatric examination were excluded from the study, as well as patients with epileptic seizures at the onset of stroke, with aphasia, with Mini - mental test <23, with verified previous dementia / cognitive impairment. Results: There is no statistically significant difference in the age of men and women, both with apnea and without apnea. In patients with apnea, heart disease was in the first place 91.8%, followed by hypertension 86.4%, Body mass index 79.1%, hyperlipidemia 50%, smoking 38.2 % and diabetes mellitus 20.9%. Hypertension was the most common risk factor in patients without apnea 83.6%, followed by heart disease 81.0%, Body mass index 60.9%, hyperlipidemia 48.21%, smoking 28.2 % and diabetes mellitus 20%. Conclusion: Heart diseases, hypertension and body mass index are significantly more frequent in patients with than in patients without sleep apnea.

Opacity of data on stroke for Bosnia and Herzegovina (B&H) is mainly due to the lack of a unified national stroke registry. This article aims to present updated epidemiological data on the etiology and risk factors for first‐ever ischemic stroke in Tuzla Canton, B&H.

Background: Sleep is a complex process involving the interactions of several brain regions, which play a key role in regulating the sleep process, particularly the brainstem, thalamus, and anterior basal brain regions. The process of sleep is accompanied by a change in body functions, as well as a change in cerebral electrical activity, which is under the control of the autonomic nervous system. Objective: The aim of the study was to analyze the frequency of stroke recurrence and disability of patients with stroke and apnea. Methods: It was analyzed 110 acute stroke patients with sleep apnea. All patients were evaluated with: Glasgow scale, The American National Institutes of Health Scale Assessment, Mini Mental Test, The Sleep and snoring Questionnaire Test, The Berlin Questionnaire Test, The Epworth Sleepiness Scale, The Stanford Sleepiness Scale, and The general sleep questionnaire. Results: The largest number of patients with apnea on admission had a degree of disability of 4, and on discharge of 1. There was a statistically significant difference between the mean values of incapacity for admission and discharge. The student’s t - test did not determine a statistically significant difference in disability according to the Rankin scale between patients with and without apnea at admission (t = 0.059, p = 0.95) and discharge (t = 0.71, p = 0.48). According to the NIHS scale, patients of both sexes with apnea had a neurological deficit of 7.55 ± 5.22 on admission and 7.1 ± 4.3 without apnea. Statistically significant difference was not found on the neurological deficit of both sexes, with and without apnea, at admission and discharge. With apnea, there were 13 relapses of stroke during one year, and without apnea in only 3 patients. Conclusion: Patients with acute stroke have a significantly higher correlation rate according to sleep apnea. There is no significant correlation in the degree of disability between patients with and without apnea.

An Retraction to this paper has been published: 10.1007/s00198-021-06031-0