Clinical trials for preventing post stroke cognitive impairment

Ankolekar, Sandeep; Geeganage, Chamila; Anderton, Peter; Hogg, Cheryl; Bath, Philip M.W.

doi:10.1016/j.jns.2010.08.052

Cited by 45 publications

(47 citation statements)

References 64 publications

(45 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The most important observation in our study was that appropriate management of vascular risk factors was associated with improved protective effect of long-term cognitive outcome among stroke patients. Several trials have assessed the effect of stroke secondary prevention drugs on recurrent stroke and survival 27 ; however, the question of whether such drugs prevent or delay cognitive decline is still relatively unexplored. 8 In this study, lipid management after stroke was found to be independently associated with a reduced risk of cognitive impairment in most patients regardless of age.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Effects of Secondary Prevention on Cognitive Function in Stroke Patients

et al. 2013

View full text Add to dashboard Cite

Background-Limited long-term follow-up data exist on the impact of appropriate secondary prevention therapies on cognitive function in patients after first-ever stroke. The aim of this study is to determine the effect of secondary prevention of vascular events on cognitive function after stroke. Methods and Results-Data were collected between 1995 and 2011 (n=4413) from the community-based South London Stroke Register covering an inner-city multiethnic source population of 271 817 inhabitants. Modified Poisson regression models were constructed to adjust for cognitive function status at 3 months, demographic and socioeconomic characteristics, case mix, stroke subtype, vascular risk factors, disability, and stroke recurrence. In patients with ischemic strokes without a history of atrial fibrillation (AF), there was a reduced risk of cognitive impairment associated with the use of different prevention treatments: (1)

show abstract

Section: Discussionmentioning

confidence: 99%

Long-Term Effects of Secondary Prevention on Cognitive Function in Stroke Patients

et al. 2013

View full text Add to dashboard Cite

show abstract

“…publication of Sano et al [153] in which neither a treatment effect nor a difference between trials of atorvastatin and simvastatin was seen [155]. There is, therefore, no evidence to recommend the use of statin therapy for the treatment of AD or VaD.…”

Section: On-treatment Outcomementioning

confidence: 99%

Hypercholesterolaemia and vascular dementia

et al. 2017

View full text Add to dashboard Cite

Correspondence: Philip Bath (Philip.bath@nottingham.ac.uk) Vascular dementia (VaD) is the second commonest cause of dementia. Stroke is the leading cause of disability in adults in developed countries, the second major cause of dementia and the third commonest cause of death. Traditional vascular risk factors -diabetes, hypercholesterolaemia, hypertension and smoking -are implicated as risk factors for VaD. The associations between cholesterol and small vessel disease (SVD), stroke, cognitive impairment and subsequent dementia are complex and as yet not fully understood. Similarly, the effects of lipids and lipid-lowering therapy on preventing or treating dementia remain unclear; the few trials that have assessed lipid-lowering therapy for preventing (two trials) or treating (four trials) dementia found no evidence to support the use of lipid-lowering therapy for these indications. It is appropriate to treat those patients with vascular risk factors that meet criteria for lipid-lowering therapy for the primary and secondary prevention of cardiovascular and cerebrovascular events, and in line with current guidelines. Managing the individual patient in a holistic manner according to his or her own vascular risk profile is recommended. Although the paucity of randomized controlled evidence makes for challenging clinical decision making, it provides multiple opportunities for on-going and future research, as discussed here.

show abstract

“…12 However, there is insufficient evidence from randomized controlled trials about the effectiveness of lifestyle intervention on preservation of cognition. [4][5][6]13 The primary objective of this study was to assess the efficacy of an intensive multifactorial intervention focused on adapting lifestyle and improving medication adherence in the prevention of cognitive decline after stroke.…”

mentioning

confidence: 99%

Multidomain Lifestyle Interventions for the Prevention of Cognitive Decline After Ischemic Stroke

Matz¹,

Teuschl²,

Firlinger³

et al. 2015

Stroke

View full text Add to dashboard Cite

4-6Modifiable risk factors for stroke such as hypertension, dyslipidaemia, diabetes mellitus, smoking, physical inactivity, and poor diet have been associated with an increased risk of cognitive impairment.7-10 Thus, it is plausible that effective secondary prevention strategies in combination with lifestyleoriented interventions adjusted to individual risk factors can Background and Purpose-Cognitive impairment occurs in ≤30% of all stroke survivors. However, effective therapies aimed at preventing poststroke cognitive decline are lacking. We assessed the efficacy of a multidomain intervention on preventing cognitive decline after stroke. Methods-In this randomized, observer-blind trial patients were recruited within 3 months after an acute stroke in 5Austrian neurological centers. Patients were assigned to a 24-month lifestyle-based multidomain intervention or standard stroke care. Primary outcomes were the cognitive subscale of the Alzheimer Disease Assessment Scale (ADAS-cog) and occurrence of cognitive decline in the composite scores of at least 2 of 5 cognitive domains at 24 months.

show abstract

Clinical trials for preventing post stroke cognitive impairment

Cited by 45 publications

References 64 publications

Long-Term Effects of Secondary Prevention on Cognitive Function in Stroke Patients

Long-Term Effects of Secondary Prevention on Cognitive Function in Stroke Patients

Hypercholesterolaemia and vascular dementia

Multidomain Lifestyle Interventions for the Prevention of Cognitive Decline After Ischemic Stroke

Contact Info

Product

Resources

About