Longitudinal Effect of Stroke on Cognition: A Systematic Review
BackgroundStroke is associated with an increased risk of dementia; however, the impact of stroke on cognition has been found to be variable, such that stroke survivors can show decline, remain stable, or revert to baseline cognitive functioning. Knowing the natural history of cognitive impairment af...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.117.006443 |
| _version_ | 1818289481168453632 |
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| author | Eugene YH Tang Obreniokibo Amiesimaka Stephanie L Harrison Emma Green Christopher Price Louise Robinson Mario Siervo Blossom CM Stephan |
| author_facet | Eugene YH Tang Obreniokibo Amiesimaka Stephanie L Harrison Emma Green Christopher Price Louise Robinson Mario Siervo Blossom CM Stephan |
| author_sort | Eugene YH Tang |
| collection | DOAJ |
| description | BackgroundStroke is associated with an increased risk of dementia; however, the impact of stroke on cognition has been found to be variable, such that stroke survivors can show decline, remain stable, or revert to baseline cognitive functioning. Knowing the natural history of cognitive impairment after stroke is important for intervention. The aim of this systematic review is to investigate the longitudinal course of cognitive function in stroke survivors. Methods and ResultsThree electronic databases (Medline, Embase, PsycINFO) were searched using OvidSP from inception to July 15, 2016. Longitudinal studies with ≥2 time points of cognitive assessment after stroke were included. In total, 5952 articles were retrieved and 14 were included. There was a trend toward significant deterioration in cognitive test scores in stroke survivors (8 studies). Cognitive stability (3 studies) and improvement (3 studies) were also demonstrated, although follow‐up time tended to be shorter in these studies. Variables associated with impairment included age, ethnicity, premorbid cognitive performance, depression, stroke location, and history of previous stroke. Associations with APOE*E4 (apolipoprotein E with the E4 allele) allele status and sex were mixed. ConclusionsStroke is associated with an increased risk of cognitive decline, but cognitive decline is not a consequence. Factors associated with decline, such as sociodemographic status, health‐related comorbidity, stroke history, and clinical features could be used in models to predict future risk of dementia after stroke. A risk model approach could identify patients at greatest risk for timely intervention to reduce the frequency or delay the onset of poststroke cognitive impairment and dementia. |
| first_indexed | 2024-12-13T02:12:57Z |
| format | Article |
| id | doaj.art-1de93e6d0fa94693aab94444eb0a8f78 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-13T02:12:57Z |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-1de93e6d0fa94693aab94444eb0a8f782022-12-22T00:02:58ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802018-01-017210.1161/JAHA.117.006443Longitudinal Effect of Stroke on Cognition: A Systematic ReviewEugene YH Tang0Obreniokibo Amiesimaka1Stephanie L Harrison2Emma Green3Christopher Price4Louise Robinson5Mario Siervo6Blossom CM Stephan7Institute of Health and Society, Newcastle University Institute of Ageing Newcastle University, Newcastle upon Tyne, UKInstitute of Health and Society, Newcastle University Institute of Ageing Newcastle University, Newcastle upon Tyne, UKDepartment of Rehabilitation, Aged and Extended Care, Repatriation General Hospital, Flinders University, Daw Park, South AustraliaDepartment of Public Health and Primary Care, Cambridge Institute of Public Health, University of Cambridge, Cambridge, UKInstitute of Neuroscience, Stroke Research Group, Newcastle University, Newcastle upon Tyne, UKInstitute of Health and Society, Newcastle University Institute of Ageing Newcastle University, Newcastle upon Tyne, UKInstitute of Cellular Medicine, Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UKInstitute of Health and Society, Newcastle University Institute of Ageing Newcastle University, Newcastle upon Tyne, UKBackgroundStroke is associated with an increased risk of dementia; however, the impact of stroke on cognition has been found to be variable, such that stroke survivors can show decline, remain stable, or revert to baseline cognitive functioning. Knowing the natural history of cognitive impairment after stroke is important for intervention. The aim of this systematic review is to investigate the longitudinal course of cognitive function in stroke survivors. Methods and ResultsThree electronic databases (Medline, Embase, PsycINFO) were searched using OvidSP from inception to July 15, 2016. Longitudinal studies with ≥2 time points of cognitive assessment after stroke were included. In total, 5952 articles were retrieved and 14 were included. There was a trend toward significant deterioration in cognitive test scores in stroke survivors (8 studies). Cognitive stability (3 studies) and improvement (3 studies) were also demonstrated, although follow‐up time tended to be shorter in these studies. Variables associated with impairment included age, ethnicity, premorbid cognitive performance, depression, stroke location, and history of previous stroke. Associations with APOE*E4 (apolipoprotein E with the E4 allele) allele status and sex were mixed. ConclusionsStroke is associated with an increased risk of cognitive decline, but cognitive decline is not a consequence. Factors associated with decline, such as sociodemographic status, health‐related comorbidity, stroke history, and clinical features could be used in models to predict future risk of dementia after stroke. A risk model approach could identify patients at greatest risk for timely intervention to reduce the frequency or delay the onset of poststroke cognitive impairment and dementia.https://www.ahajournals.org/doi/10.1161/JAHA.117.006443cognitioncognitive impairmentdementiarisk factors/global assessmentstroke |
| spellingShingle | Eugene YH Tang Obreniokibo Amiesimaka Stephanie L Harrison Emma Green Christopher Price Louise Robinson Mario Siervo Blossom CM Stephan Longitudinal Effect of Stroke on Cognition: A Systematic Review Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cognition cognitive impairment dementia risk factors/global assessment stroke |
| title | Longitudinal Effect of Stroke on Cognition: A Systematic Review |
| title_full | Longitudinal Effect of Stroke on Cognition: A Systematic Review |
| title_fullStr | Longitudinal Effect of Stroke on Cognition: A Systematic Review |
| title_full_unstemmed | Longitudinal Effect of Stroke on Cognition: A Systematic Review |
| title_short | Longitudinal Effect of Stroke on Cognition: A Systematic Review |
| title_sort | longitudinal effect of stroke on cognition a systematic review |
| topic | cognition cognitive impairment dementia risk factors/global assessment stroke |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.117.006443 |
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