Post-Stroke Cognitive Impairment: Epidemiology, Risk Factors, and Management

Abstract

Stroke, characterized as a neurological deficit of cerebrovascular cause, is very common in older adults. Increasing evidence suggests stroke contributes to the risk and severity of cognitive impairment. People with cognitive impairment following stroke often face with quality-of-life issues and require ongoing support, which have a profound effect on caregivers and society. The high morbidity of post-stroke cognitive impairment (PSCI) demands effective management strategies, in which preventive strategies are more appealing, especially those targeting towards modifiable risk factors. In this review article, we attempt to summarize existing evidence and knowledge gaps on PSCI: elaborating on the heterogeneity in current definitions, reporting the inconsistent findings in PSCI prevalence in the literature, exploring established or less established predictors, outlining prevention and treatment strategies potentially effective or currently being tested, and proposing promising directions for future research.

Potential Benefits of Music Therapy on Stroke Rehabilitation

“…Poststroke cognitive impairment refers to a series of cognitive damages with different symptoms and severity after stroke. Due to the influence of multiple factors, including etiology, type, location, and complications of stroke, the clinical manifestations of cognitive dysfunction after stroke are multiple and are associated with memory disorders, learning ability disorders, attention disorders, sensory and perceptual disorders, personality changes, and behavioral abnormalities [ 4 , 88 – 91 ]. The manifestations of poststroke cognitive impairment are not single but actually often overlap and interact with each other in complex ways.…”

Transcutaneous auricular vagus nerve stimulation in poststroke cognitive impairment: protocol for a randomised controlled trial

“…Cognitive function tends to decline rapidly over a short period after acute stroke, and then progressively (and at least partly) recover. 1 Yet because of the unpredictability of recovery and symptom onset latency, identification is often challenging and time-consuming. In this study, we will limit inclusion to participants who are 2–4 weeks poststroke onset, to identify early cognitive impairment.…”

“…Currently, the most relevant PSCI-prevention measures are acute therapy and recurrence prevention. 1 However, there are no unambiguously successful therapeutic techniques, and prospective pharmaceuticals have yet to show efficacy in decreasing or preventing cognitive deterioration following stroke. Acetylcholinesterase inhibitors (AChEIs) and memantine, which are approved for use in Alzheimer’s disease (AD), have shown some clinical benefits in vascular dementia.…”

“…Among stroke sequelae, poststroke cognitive impairment (PSCI) is common, affecting 17.6%-83% of stroke survivors, depending on assessment timing, research setting, demographics and cognitive test/cut-off. 1 PSCI is a clinical syndrome characterised by cognitive deterioration after a clinical cerebrovascular incident, which persists for up to 6 months; it includes both PSCI no dementia and the more severe form, poststroke dementia. 2 3 Core impaired domains include executive function, memory, attention, language and visuospatial function, which not only lead to disability, dependence and low quality of life, 4 but are closely associated with high risk of recurrent ischaemic stroke 5 and reduced 5-year survival.…”

Comparative efficacy of 5 non-pharmacological therapies for adults with post-stroke cognitive impairment: A Bayesian network analysis based on 55 randomized controlled trials

“…Post-stroke cognitive impairment (PSCI) is a common comorbidity of stroke, and the prevalence of it varies enormously across studies (17.6–83%), depending on the time of assessment, the study environment, the demographic variables, and the numerous cognitive tests and cut-offs that were utilized ( 1 ). PSCI is defined as a clinical syndrome characterized by any sort of cognitive neurodegeneration after stroke, ranging from mild impairment to a more severe form: post-stroke dementia ( 2 , 3 ).…”