Cognitive Impairment and Dementia 20 Months after Stroke

Lindén, Thomas; Skoog, Ingmar; Fagerberg, Björn; Steen, Bertil; Blomstrand, Christian

doi:10.1159/000073974

Cited by 99 publications

(80 citation statements)

References 31 publications

(36 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…37,38 Evidence from epidemiological studies undoubtedly confirms that stroke is a strong predictor of cognitive decline and dementia. 39 The natural evolution from stroke to dementia goes through a mild vascular cognitive impairment.…”

Section: Cognitive Disorders In the Chronic Phase Of Strokementioning

confidence: 99%

“…Additional specific interventions include systemic control of vasoactive, hemorheologic and metabolic mechanisms implicated in the neuronal damage, related to functional and cognitive stroke outcome. 37 The hypothesis of a possible relationship between markers of systemic inflammation and cognitive dysfunctions raises the question of how rational the option of applying non-steroidal anti-inflammatory drugs in a proper therapeutic window will be, especially during the acute phase of stroke, to prevent cognitive decline and dementia. 74 Future prospective studies on the incidence and clinical manifestation of cognitive disorders after stroke might offer possibilities of detecting unknown risk factors of cognitive decline and novel opportunities for successful therapeutic impact.…”

Section: Therapeutic Opportunities and Guidelines For Future Studiesmentioning

confidence: 99%

See 1 more Smart Citation

Post-Stroke Cognitive Impairment – Phenomenology and Prognostic Factors

Danovska¹,

Stamenov²,

Alexandrova³

et al. 2012

JofIMAB

View full text Add to dashboard Cite

Stroke patients are at higher risk of developing cognitive impairment. Cognitive dysfunctions, especially progressive ones, worsen stroke prognosis and outcome. A longitudinal follow-up of cognitive disorders, however, is rendered difficult by their heterogeneity and the lack of definitions generally agreed upon. Stroke is a major cause of cognitive deficit. The identification of risk factors, clinical determinants and laboratory markers of post-stroke cognitive deficit may help detect patients at increased risk of cognitive deterioration, and prevent or delay the occurrence of poststroke cognitive impairments. Though inflammatory processes have been implicated in the pathogenesis of stroke, their role in the complex pathophysiological mechanisms of post-stroke cognitive impairment is not completely understood. Evidence suggests that elevated serum Creactive protein is associated with both the increased risk of stroke and post-stroke cognitive deficit. The hypothesis of a possible relationship between markers of systemic inflammation and cognitive dysfunctions raises the question of how rational the option of applying non-steroidal antiinflammatory drugs in a proper therapeutic window will be, especially during the acute phase of stroke, to prevent cognitive decline and dementia.

show abstract

Section: Cognitive Disorders In the Chronic Phase Of Strokementioning

confidence: 99%

Section: Therapeutic Opportunities and Guidelines For Future Studiesmentioning

confidence: 99%

Post-Stroke Cognitive Impairment – Phenomenology and Prognostic Factors

Danovska¹,

Stamenov²,

Alexandrova³

et al. 2012

JofIMAB

View full text Add to dashboard Cite

show abstract

“…In cohort studies, the relative risk for dementia after stroke is between two and four compared to age-matched healthy persons. [30][31][32] Regarding LACS, the severity of cognitive impairment seems to be related to the severity of leukoaraiosis. 13,33 Even if LACS often are mild, they may be associated with cognitive impairment on longer term, more so than other types of strokes.…”

Section: Epidemiologymentioning

confidence: 99%

Cognitive Impairment in Lacunar Strokes

Appelros¹

2013

US Neurology

View full text Add to dashboard Cite

Vascular cognitive impairment is closely related to stroke. Each condition is a risk factor for the other. Cognitive impairment is a symptom that makes it difficult for a stroke patient to live at home. In this review paper, different types of vascular cognitive impairment are discussed, with emphasis on cognitive impairment related to lacunar strokes (LACS). Symptoms, diagnostics, epidemiology, treatment, and prognosis are surveyed. LACS are often associated with leukoaraiosis, which is related to subcortical ischemic vascular dementia. Even if LACS often are mild, they may therefore be associated with cognitive impairment on longer term. KeywordsStroke, vascular cognitive impairment, leukoaraiosis, small vessel disease Disclosure: The author has no conflicts of interest to declare. DefinitionsAccording to ICD-10, a diagnosis of dementia requires: (1) impairment in short-and long-term memory; (2) impairment in abstract thinking, judgement, higher cortical function, or personality change; (3) memory impairment and intellectual impairment, which cause significant social and occupational impairments; and (4) the occurrence of these traits when patients are not in a state of delirium.Cognitive impairment is a continuum, affecting different cognitive domains at different rates, from different causes. 4 The definition of dementia requires memory impairment plus involvement of at least one other cognitive domain. This definition is less appropriate for vascular cognitive impairment (VCI), because in VCI memory is often less affected than executive functions. In this paper, the terms cognitive impairment and VCI are used whenever possible.Delirium, or confusional state, is a more or less acute disorder of attention and global cognition (memory and perception), which is reversible. 5 Delirium is almost always caused by a provoking event, such as an infection, a metabolic condition, or a psychotropic drug.People with pre-existing cognitive impairment are at higher risk for developing delirium.LACS result from occlusion of the penetrating arteries that provide blood to the brain's deep structures. A corresponding infarction is often small, within 10 mm and affects the deep nuclei of the brain or different neural pathways to and from the cortex. 6,7 Compared to larger infarctions that involve the cortex, patients with LACS often have a lower grade of stroke severity 1 and a better short-time prognosis. 8 Therefore, LACS have been considered as relatively benign. 7On the other hand, LACS are often seen together with leukoaraiosis or cerebral white matter changes. 9,10 These are radiologic findings with bilateral patchy or diffuse areas of hyperintensities of the cerebral white matter on T2-weighted MRI. Leukoaraiosis is probably caused by chronic ischemia in the white matter, leading to loss of myelin and axons, and ultimately to gliosis and atrophy. 11 Leukoaraiosis is related to cognitive impairment. 12,13 Classification of Cognitive ImpairmentNot so many years ago, a rather strict distinction was made between th...

show abstract

“…Global cerebral atrophy is associated with a higher risk of PSD (Linden et al, 2004;Desmond et al, 2000;Tang et al, 2004;Altieri et al, 2004;Ivan et al, 2004;Tatemichi et al, 1993).…”

Section: Neuroimaging Charateristicsmentioning

confidence: 99%

“…The risk of PSD and its severity are not influenced by the type of stroke (ischemic or hemorrhagic) (Linden et al, 2004;Pohjasvaara et al, 1998;Barba et al, 2000;Henon et al, 2001;Madureira et al, 2001;Rasquin et al, 2004). However, differences in survival rates between stroke subtypes are making the results difficult to interpret.…”

Section: Stroke Characteristicsmentioning

confidence: 99%