Cognitive impairment after ischemic and hemorrhagic stroke: a scientific statement from the American Heart Association/American Stroke Association
<p><strong>Purpose:</strong></p> Cognitive impairment is a common consequence of stroke and has direct implications for poststroke functioning and quality of life, including the ability to maintain a job, live independently, sustain interpersonal relationships, and drive a ve...
| Main Authors: | , , , , , , , , , |
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| Other Authors: | |
| Format: | Journal article |
| Language: | English |
| Published: |
American Heart Association
2023
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| _version_ | 1797112492467421184 |
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| author | El Husseini, N Katzan, IL Rost, NS Lehman Blake, M Byun, E Pendlebury, ST Aparicio, HJ Marquine, MJ Gottesman, RF Smith, EE |
| author2 | American Heart Association Stroke Council |
| author_facet | American Heart Association Stroke Council El Husseini, N Katzan, IL Rost, NS Lehman Blake, M Byun, E Pendlebury, ST Aparicio, HJ Marquine, MJ Gottesman, RF Smith, EE |
| author_sort | El Husseini, N |
| collection | OXFORD |
| description | <p><strong>Purpose:</strong></p>
Cognitive impairment is a common consequence of stroke and has direct implications for poststroke functioning and quality of life, including the ability to maintain a job, live independently, sustain interpersonal relationships, and drive a vehicle. In this scientific statement, we critically appraise the literature on the prevalence, diagnosis, and management of poststroke cognitive impairment (PSCI) and provide a framework for clinical care while highlighting gaps that merit further study.
<p><strong>Methods:</strong></p>
We performed a scoping literature review of randomized controlled clinical trials, prospective and retrospective cohort studies, case-control studies, clinical guidelines, review articles, and editorials on the incidence and prevalence, natural history, diagnosis, and management of PSCI. Scoping reviews determine the scope of a body of literature on a given topic to indicate the volume of literature and the studies currently available and provide an overview of its focus.
<p><strong>Results:</strong></p>
PSCI is common after stroke, especially in the first year, and ranges from mild to severe. Although cognitive impairment is reversible in some cases early after stroke, up to one-third of individuals with stroke develop dementia within 5 years. The pathophysiology is not yet fully elucidated but is likely attributable to an acute stroke precipitating a series of pathological events, often in the setting of preexisting microvascular and neurodegenerative changes. Screening for associated comorbidities and interdisciplinary management are integral components of the care of individuals with PSCI. There is a need for prospective studies evaluating the individual trajectory of PSCI and the role of the acute vascular event in the predisposition for Alzheimer disease and related dementias, as well as high-quality, randomized clinical trials focused on PSCI management. |
| first_indexed | 2024-03-07T08:24:56Z |
| format | Journal article |
| id | oxford-uuid:97f67f3b-7860-440e-9235-0bbe220c4c87 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T08:24:56Z |
| publishDate | 2023 |
| publisher | American Heart Association |
| record_format | dspace |
| spelling | oxford-uuid:97f67f3b-7860-440e-9235-0bbe220c4c872024-02-14T09:32:16ZCognitive impairment after ischemic and hemorrhagic stroke: a scientific statement from the American Heart Association/American Stroke AssociationJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:97f67f3b-7860-440e-9235-0bbe220c4c87EnglishSymplectic ElementsAmerican Heart Association2023El Husseini, NKatzan, ILRost, NSLehman Blake, MByun, EPendlebury, STAparicio, HJMarquine, MJGottesman, RFSmith, EE American Heart Association Stroke CouncilCouncil on Cardiovascular and Stroke NursingCouncil on Cardiovascular Radiology and InterventionCouncil on HypertensionCouncil on Lifestyle and Cardiometabolic Health<p><strong>Purpose:</strong></p> Cognitive impairment is a common consequence of stroke and has direct implications for poststroke functioning and quality of life, including the ability to maintain a job, live independently, sustain interpersonal relationships, and drive a vehicle. In this scientific statement, we critically appraise the literature on the prevalence, diagnosis, and management of poststroke cognitive impairment (PSCI) and provide a framework for clinical care while highlighting gaps that merit further study. <p><strong>Methods:</strong></p> We performed a scoping literature review of randomized controlled clinical trials, prospective and retrospective cohort studies, case-control studies, clinical guidelines, review articles, and editorials on the incidence and prevalence, natural history, diagnosis, and management of PSCI. Scoping reviews determine the scope of a body of literature on a given topic to indicate the volume of literature and the studies currently available and provide an overview of its focus. <p><strong>Results:</strong></p> PSCI is common after stroke, especially in the first year, and ranges from mild to severe. Although cognitive impairment is reversible in some cases early after stroke, up to one-third of individuals with stroke develop dementia within 5 years. The pathophysiology is not yet fully elucidated but is likely attributable to an acute stroke precipitating a series of pathological events, often in the setting of preexisting microvascular and neurodegenerative changes. Screening for associated comorbidities and interdisciplinary management are integral components of the care of individuals with PSCI. There is a need for prospective studies evaluating the individual trajectory of PSCI and the role of the acute vascular event in the predisposition for Alzheimer disease and related dementias, as well as high-quality, randomized clinical trials focused on PSCI management. |
| spellingShingle | El Husseini, N Katzan, IL Rost, NS Lehman Blake, M Byun, E Pendlebury, ST Aparicio, HJ Marquine, MJ Gottesman, RF Smith, EE Cognitive impairment after ischemic and hemorrhagic stroke: a scientific statement from the American Heart Association/American Stroke Association |
| title | Cognitive impairment after ischemic and hemorrhagic stroke: a scientific statement from the American Heart Association/American Stroke Association |
| title_full | Cognitive impairment after ischemic and hemorrhagic stroke: a scientific statement from the American Heart Association/American Stroke Association |
| title_fullStr | Cognitive impairment after ischemic and hemorrhagic stroke: a scientific statement from the American Heart Association/American Stroke Association |
| title_full_unstemmed | Cognitive impairment after ischemic and hemorrhagic stroke: a scientific statement from the American Heart Association/American Stroke Association |
| title_short | Cognitive impairment after ischemic and hemorrhagic stroke: a scientific statement from the American Heart Association/American Stroke Association |
| title_sort | cognitive impairment after ischemic and hemorrhagic stroke a scientific statement from the american heart association american stroke association |
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