Screening may detect cognitive impairment, dementia early in stroke survivors

By ľ¹ÏÖ±²¥ News

Ok Sotnykova/iStock via Getty Images
(Ok Sotnykova/iStock via Getty Images)

More than half of U.S. adults who survive strokes develop cognitive impairments in the year that follows, a new science report says. As many as 1 in 3 survivors will develop dementia within five years.

A new scientific statement from the ľ¹ÏÖ±²¥ and American Stroke Association summarizes the latest research linking stroke to subsequent cognitive impairment and dementia. It published Monday in the journal .

"Cognitive impairment is an often underreported and underdiagnosed yet very common condition that stroke survivors frequently deal with," Dr. Nada El Husseini, chair of the statement's writing committee, said in a news release. She is an associate professor of neurology at Duke University Medical Center in Durham, North Carolina.

"Stroke survivors should be systematically evaluated for cognitive impairment so that treatment may begin as soon as possible after signs appear," she said.

Roughly 9.4 million U.S. adults – 3.6% of the population – report having had a stroke, according to the latest AHA statistics. Cognitive issues may develop immediately following a stroke or years later.

"Cognitive impairment after stroke ranges from mild impairment to dementia and may affect many aspects of life, such as remembering, thinking, planning, language and attention, as well as a person's ability to work, drive or live independently," El Husseini said.

The statement notes that up to 60% of stroke survivors experience cognitive impairment within the first year, most often within the first two weeks of their stroke. For about 40% of survivors, the impairment is not severe enough to meet the criteria for dementia but still impacts their quality of life. Up to 20% of survivors who experience mild cognitive impairment fully recover their cognitive function, usually within six months of a stroke.

Cognitive impairment after a stroke often is linked to other problems, including physical disabilities, sleep disorders, behavioral and personality changes, depression and other neuropsychological changes.

Although brief tests of 30 minutes or less are widely used to screen for cognitive deficits following a stroke, there is currently no gold standard. The statement's authors emphasize the importance of screening stroke survivors for cognitive deficits during the initial hospitalization and assessing them for changes in cognitive skills over time, especially if a survivor experiences difficulty with daily life activities. The statement encourages health care professionals to offer guidance to patients and caregivers regarding home safety, returning to work and driving after having a stroke.

Stroke risk factors, such as high blood pressure, high cholesterol, Type 2 diabetes and atrial fibrillation, should be addressed to prevent another stroke and potential worsening of cognitive impairments, the report said.

Future research, the authors said, can address how cognitive impairments develop following a stroke and how other factors, such as infection and frailty, may play a role. Best practices for cognitive screening after a stroke that take demographic, cultural and linguistic factors into consideration also are needed.

"Perhaps the most pressing need, however, is the development of effective and culturally relevant treatments for post-stroke cognitive impairment," El Husseini said. "We hope to see big enough clinical trials that assess various techniques, medications and lifestyle changes in diverse groups of patients that may help improve cognitive function."


ľ¹ÏÖ±²¥ News Stories

ľ¹ÏÖ±²¥ News covers heart disease, stroke and related health issues. Not all views expressed in ľ¹ÏÖ±²¥ News stories reflect the official position of the ľ¹ÏÖ±²¥. Statements, conclusions, accuracy and reliability of studies published in ľ¹ÏÖ±²¥ scientific journals or presented at ľ¹ÏÖ±²¥ scientific meetings are solely those of the study authors and do not necessarily reflect the ľ¹ÏÖ±²¥â€™s official guidance, policies or positions.

Copyright is owned or held by the ľ¹ÏÖ±²¥., and all rights are reserved. Permission is granted, at no cost and without need for further request, for individuals, media outlets, and non-commercial education and awareness efforts to link to, quote, excerpt from or reprint these stories in any medium as long as no text is altered and proper attribution is made to ľ¹ÏÖ±²¥ News.

Other uses, including educational products or services sold for profit, must comply with the ľ¹ÏÖ±²¥â€™s Copyright Permission Guidelines. See full terms of use. These stories may not be used to promote or endorse a commercial product or service.

HEALTH CARE DISCLAIMER: This site and its services do not constitute the practice of medical advice, diagnosis or treatment. Always talk to your health care provider for diagnosis and treatment, including your specific medical needs. If you have or suspect that you have a medical problem or condition, please contact a qualified health care professional immediately. If you are in the United States and experiencing a medical emergency, call 911 or call for emergency medical help immediately.