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Cognitive impairment six months after ischaemic stroke: a profile from the ASPIRE-S study
BACKGROUND: Cognitive impairment commonly occurs in the acute phase post-stroke, but may persist with over half of all stroke survivors experiencing some form of long-term cognitive deficit. Recent evidence suggests that optimising secondary prevention adherence is a critical factor in preventing re...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4359388/ https://www.ncbi.nlm.nih.gov/pubmed/25879880 http://dx.doi.org/10.1186/s12883-015-0288-2 |
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author | Mellon, Lisa Brewer, Linda Hall, Patricia Horgan, Frances Williams, David Hickey, Anne |
author_facet | Mellon, Lisa Brewer, Linda Hall, Patricia Horgan, Frances Williams, David Hickey, Anne |
author_sort | Mellon, Lisa |
collection | PubMed |
description | BACKGROUND: Cognitive impairment commonly occurs in the acute phase post-stroke, but may persist with over half of all stroke survivors experiencing some form of long-term cognitive deficit. Recent evidence suggests that optimising secondary prevention adherence is a critical factor in preventing recurrent stroke and the incidence of stroke-related cognitive impairment and dementia. The aim of this study was to profile cognitive impairment of stroke survivors at six months, and to identify factors associated with cognitive impairment post-stroke, focusing on indicators of adequate secondary prevention and psychological function. METHODS: Participants were assessed at six months following an ischaemic stroke as part of the Action on Secondary Prevention Interventions and Rehabilitation in Stroke study (ASPIRE-S), which examined the secondary preventive and rehabilitative profile of patients in the community post-stroke. Cognitive impairment was measured using the Montreal Cognitive Assessment (MoCA). RESULTS: Two-hundred and fifty-six stroke patients were assessed at six months. Over half of the sample (56.6%) were found to have cognitive impairment, with significant associations between cognitive impairment and female sex (odds ratio (OR) = 1.6, 95% CI 1.01-2.57) and history of cerebrovascular disease (OR = 2.22, 95% CI 1.38-3.59). Treatment with antihypertensive medications (OR = .65, 95% CI .44-.96) and prescription of anticoagulant therapy (OR = .41, 95% CI .26-.68) were associated with reduced likelihood of cognitive impairment, however increasing number of total prescribed medications was moderately associated with poorer cognitive impairment (OR = 1.12, 95% CI 1.04-1.19). CONCLUSIONS: Findings reveal levels of cognitive impairment at 6 months post-stroke that are concerning. Encouragingly, aspects of secondary prevention were identified that may be protective in reducing the incidence of cognitive impairment post-stroke. Neuropsychological rehabilitation post-stroke is also required as part of stroke rehabilitation models to meet the burden of post-stroke cognitive impairment. |
format | Online Article Text |
id | pubmed-4359388 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-43593882015-03-15 Cognitive impairment six months after ischaemic stroke: a profile from the ASPIRE-S study Mellon, Lisa Brewer, Linda Hall, Patricia Horgan, Frances Williams, David Hickey, Anne BMC Neurol Research Article BACKGROUND: Cognitive impairment commonly occurs in the acute phase post-stroke, but may persist with over half of all stroke survivors experiencing some form of long-term cognitive deficit. Recent evidence suggests that optimising secondary prevention adherence is a critical factor in preventing recurrent stroke and the incidence of stroke-related cognitive impairment and dementia. The aim of this study was to profile cognitive impairment of stroke survivors at six months, and to identify factors associated with cognitive impairment post-stroke, focusing on indicators of adequate secondary prevention and psychological function. METHODS: Participants were assessed at six months following an ischaemic stroke as part of the Action on Secondary Prevention Interventions and Rehabilitation in Stroke study (ASPIRE-S), which examined the secondary preventive and rehabilitative profile of patients in the community post-stroke. Cognitive impairment was measured using the Montreal Cognitive Assessment (MoCA). RESULTS: Two-hundred and fifty-six stroke patients were assessed at six months. Over half of the sample (56.6%) were found to have cognitive impairment, with significant associations between cognitive impairment and female sex (odds ratio (OR) = 1.6, 95% CI 1.01-2.57) and history of cerebrovascular disease (OR = 2.22, 95% CI 1.38-3.59). Treatment with antihypertensive medications (OR = .65, 95% CI .44-.96) and prescription of anticoagulant therapy (OR = .41, 95% CI .26-.68) were associated with reduced likelihood of cognitive impairment, however increasing number of total prescribed medications was moderately associated with poorer cognitive impairment (OR = 1.12, 95% CI 1.04-1.19). CONCLUSIONS: Findings reveal levels of cognitive impairment at 6 months post-stroke that are concerning. Encouragingly, aspects of secondary prevention were identified that may be protective in reducing the incidence of cognitive impairment post-stroke. Neuropsychological rehabilitation post-stroke is also required as part of stroke rehabilitation models to meet the burden of post-stroke cognitive impairment. BioMed Central 2015-03-12 /pmc/articles/PMC4359388/ /pubmed/25879880 http://dx.doi.org/10.1186/s12883-015-0288-2 Text en © Mellon et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Mellon, Lisa Brewer, Linda Hall, Patricia Horgan, Frances Williams, David Hickey, Anne Cognitive impairment six months after ischaemic stroke: a profile from the ASPIRE-S study |
title | Cognitive impairment six months after ischaemic stroke: a profile from the ASPIRE-S study |
title_full | Cognitive impairment six months after ischaemic stroke: a profile from the ASPIRE-S study |
title_fullStr | Cognitive impairment six months after ischaemic stroke: a profile from the ASPIRE-S study |
title_full_unstemmed | Cognitive impairment six months after ischaemic stroke: a profile from the ASPIRE-S study |
title_short | Cognitive impairment six months after ischaemic stroke: a profile from the ASPIRE-S study |
title_sort | cognitive impairment six months after ischaemic stroke: a profile from the aspire-s study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4359388/ https://www.ncbi.nlm.nih.gov/pubmed/25879880 http://dx.doi.org/10.1186/s12883-015-0288-2 |
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