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Post‐stroke cognitive decline: an update and perspectives for clinical research
Author(s) -
Brainin M.,
Tuomilehto J.,
Heiss W.D.,
Bornstein N. M.,
Bath P. M. W.,
Teuschl Y.,
Richard E.,
Guekht A.,
Quinn T.
Publication year - 2015
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.12626
Subject(s) - stroke (engine) , medicine , cognitive decline , dementia , cognition , neuropsychology , neurovascular bundle , physical medicine and rehabilitation , psychological intervention , vascular dementia , physical therapy , intervention (counseling) , psychiatry , disease , surgery , mechanical engineering , engineering
The close relationship between stroke and dementia is an important health issue. Ischaemic stroke can facilitate the onset of vascular dementia as well as aggravate pre‐existing cognitive decline. The onset of cognitive decline may become manifest immediately following the onset of ischaemic stroke, but often there is a delay in the development of cognitive decline after a stroke. This delay can be seen as a therapeutic time window allowing interventions to be applied to preserve cognition following stroke. Both neurodegenerative and vascular mechanisms are activated and probably result in overlapping processes within the neurovascular unit. This review focuses on the incidence and prevalence of cognitive decline following stroke, predisposing stroke aetiologies, pre‐stroke decline, imaging factors and biomarkers. Outcomes are discussed in relation to timing of assessment and neuropsychological tests used for evaluation of cognitive decline in ischaemic stroke patients. Including such tests in routine evaluations of stroke patients after some weeks or months is recommended. Finally, an outlook on ongoing and planned intervention trials is added and some recommendations for future research are proposed.