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What is post-stroke cognitive impairment?

Professor Anne Hickey

Professor of Psychology and Deputy Dean for Positive Education, RCSI, Division of Population Health Sciences, Royal College of Surgeons in Ireland

Stroke is a leading cause of death and disability worldwide. This will increase considerably in coming decades as people live longer. Therefore we must answer the question: What is post-stroke cognitive impairment?

Many are aware of the physical disabilities after stroke but are less aware of the cognitive problems that can arise. These can include impaired memory and concentration. Often, stroke survivors can find these problems the most debilitating consequences.

Dementia can occur as a result of stroke

Cognitive impairment after stroke is an under-researched topic internationally and is a critical area to better understand. While cognitive impairment after stroke is frequently mild or moderate, one in ten people can develop dementia after their first stroke, and more than one in three people who have a recurrent stroke may develop dementia.

The StrokeCog study, led by Professor Anne Hickey at RCSI in partnership with colleagues in Beaumont Hospital and the Economic and Social Research Institute (ESRI), involves modelling and modifying the consequences of stroke-related cognitive impairment through an intervention.

Physical rehab gets more attention than mental rehabilitation

Rehabilitation of cognitive difficulties has received very little attention compared with physical rehabilitation. The StrokeCog study aims to address the lack of research in this area. It does so by examining stroke-related cognitive impairment in a number of ways:

  • Building an innovative, epidemiological model that tracks post-stroke cognitive impairment and dementia progression over time.
  • Projecting from now until 2046.
  • Evaluating the effects of introducing cognitive rehabilitation post-stroke to reduce the impact of cognitive impairment.
  • Working with those effected to develop and test a post-stroke cognitive rehabilitation intervention in a pilot randomised controlled trial.
  • Costing post-stroke cognitive impairment and its continuum to dementia. Furthermore, conducting an evaluation of the potential cost-effectiveness of cognitive rehabilitation interventions to reduce post-stroke cognitive impairment.

Speaking on the StrokeCog study, Professor Hickey said, “The StrokeCog study combines population level projections and costings with the development of an intervention to address cognitive impairment after stroke. This provides vital information to the Irish and international stroke community that is not currently available. This includes information on the extent of post-stroke cognitive impairment currently and in the next 25 years, the associated costs to the healthcare budget of post-stroke cognitive impairment, and the feasibility of introducing a cognitive intervention to rehabilitate those who experience cognitive impairment after stroke.”

A conference is planned for 2020, involving patients and family members, along with national and international stroke experts, in presenting StrokeCog, perspectives and current evidence. 

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