Management of acute ischaemic stroke in patients with dementia

Šubic, Ana; Čermáková, Pavla; Norrving, Bo; Winblad, Bengt; Euler, Mia von; Kramberger, Milica G.; Eriksdotter, Maria; García-Ptacek, Sara

doi:10.1111/joim.12588

Cited by 44 publications

(44 citation statements)

References 140 publications

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“…Because many diseases can affect the reliability of the results of this study, patients also suffering from clinical situations involving dementia, depression, atrial fibrillation, previous respiratory diseases-which are very common comorbidities-were excluded from the research. In addition, treatment with warfarin or any other treatment that may have also affected the results was checked and the participants were excluded [28,29].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Respiratory Muscular Strength Compared to Predicted Values in Patients with Stroke

Ramos

Silva

Buchaim

et al. 2020

IJERPH

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The purpose of this study was to evaluate the inspiratory and expiratory muscle strength of individuals affected by stroke and to compare it with the predicted values in the literature considering their corresponding age. Respiratory muscle strength was evaluated in 22 elderly people who had sequels of stroke, four with right hemiparesis, 16 with left hemiparesis and two with bilateral, of ages ranging from 34 to 82 years. The collected data were submitted to statistical analysis using a Mann-Whitney test to evaluate if there was a significant difference in the average data collected when compared with a mean of the predicted data in the literature. Fourteen men and eight women were evaluated, who obtained mean values of 71.85 cmH 2 O and 57.75 cmH 2 O, respectively, for a maximal inspiratory pressure (MIP), and when compared to the predicted values for men and women, 105.41 cmH 2 O (p-value 0.0019) and 80.57 cmH 2 O (p-value 0.00464) were significantly lower. For a maximal expiratory pressure (MEP), the mean value obtained for men was 62.28 cmH 2 O and 49.5 cmH 2 O for women, whereas the predicted values in the literature were 114.79 cmH 2 O (p-value < 0.0001) and 78, 46 cmH 2 O (p-value 0.0059), respectively. In the statistical analysis, it was possible to notice that the studied population did not reach the predicted age indexes and that there was a significant difference between the median columns. In conclusion, there is a weakness in the respiratory muscles of hemiparetic men and women due to stroke.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Respiratory Muscular Strength Compared to Predicted Values in Patients with Stroke

Ramos

Silva

Buchaim

et al. 2020

IJERPH

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“…To reduce their burden, identification of stroke mechanisms and treatment of risk factors is crucial. The cornerstones of secondary prevention are antiplatelet therapy in non-embolic stroke, treatment of hypertension, diabetes, hyperlipidemia, anticoagulant treatment in patients with atrial fibrillation (AF), management of lifestyle risk factors (such as smoking and obesity), and early carotid revascularization in patients with ipsilateral severe carotid artery stenosis [4]. Although advances in carotid revascularization have contributed to the improvement in patient outcomes, the absolute effect on population level compared to a pharmacological secondary prevention is small [3].…”

Section: Introductionmentioning

confidence: 99%

“…Depending on dementia severity, stroke is three to seven times more common in patients with dementia compared to dementia-free individuals [4]. Hypertension, diabetes, and hyperlipidemia predispose individuals not only to vascular and mixed dementia, but also to Alzheimer's disease (AD).…”

Section: Introductionmentioning

confidence: 99%

“…Hypertension, diabetes, and hyperlipidemia predispose individuals not only to vascular and mixed dementia, but also to Alzheimer's disease (AD). Overlap between these subtypes in clinical presentation and pathology is common [7]; moreover, cerebrovascular lesions may lower the threshold for clinical manifestation of AD [4]. Much of the research on secondary prevention has been performed in younger and healthier subjects, while the burden of stroke is highest in the oldest subset of the population [8].…”

Section: Introductionmentioning

confidence: 99%

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Secondary Stroke Prevention After Ischemic Stroke in Patients with Alzheimer’s Disease and Other Dementia Disorders

Županič

Kramberger

Euler

et al. 2020

JAD

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Background: Recurrent ischemic stroke (IS) increases the risk of cognitive decline. To lower the risk of recurrent IS, secondary prevention is essential. Objective: Our aim was to compare post-discharge secondary IS prevention and its maintenance up to 3 years after first IS in patients with and without Alzheimer's disease and other dementia disorders. Methods: Prospective open-cohort study 2007-2014 from the Swedish national dementia registry (SveDem) and the Swedish national stroke registry (Riksstroke). Patients with dementia who experienced an IS (n = 1410; 332 [23.5%] with Alzheimer's disease) were compared with matched non-dementia IS patients (n = 7150). We analyzed antiplatelet, anticoagulant, blood pressure lowering, and statin treatment as planned medication initiation at discharge and actual dispensation of medications at first, second, and third year post-stroke. Results: At discharge, planned initiation of medication was higher in patients with dementia compared to non-dementia patients for antiplatelets (OR with 95% CI for fully adjusted models 1.23 [1.02-1.48]) and lower for blood pressure lowering medication (BPLM; 0.57 [0.49-0.67]), statins (0.57 [0.50-0.66]), and anticoagulants (in patients with atrial fibrillation-AF; 0.41 [0.32-0.53]). When analysis for antiplatelets was stratified according to the presence of AF, ORs for receiving

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“…In A. Subic et al ., , one of the affiliations for the first and sixth author, Dr. Subic and Dr. Kramberger, was missed in the published version. The complete list of affiliations is shown below:…”

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confidence: 99%