Long-Term Outcomes in Stroke Patients with Cognitive Impairment: A Population-Based Study

Area of Science:

• Neurology
• Public Health
• Gerontology

Background:

• Stroke is a leading cause of long-term disability, often resulting in cognitive deficits.
• Early post-stroke cognitive function is a critical predictor of long-term outcomes.
• Understanding the trajectory of cognitive changes is essential for patient management.

Purpose of the Study:

• To assess the five-year outcomes of patients experiencing cognitive deficits within three months post-stroke.
• To evaluate the association between cognitive function changes and dependency, mortality, depression, and institutionalization.
• To identify the impact of cognitive deterioration on long-term stroke survivor health.

Main Methods:

• Utilized population-based data from the South London Stroke Register (1995-2018).
• Assessed cognitive function using the Abbreviated Mental Test or Mini-Mental State Examination.
• Employed multivariable Poisson regression models to analyze associations and relative risks (RRs).

Main Results:

• Approximately one-third of stroke survivors showed cognitive improvement, deterioration, or remained unchanged within three months.
• Post-stroke cognitive impairment was linked to a 30-90% increased five-year risk of mortality, dependency, depression, and institutionalization.
• A 10% or greater cognitive decline between 7 days and 3 months post-stroke approximately doubled the one-year risk of mortality, dependency, and institutionalization.

Conclusions:

• Cognitive deficits and deterioration following stroke are significant predictors of adverse long-term outcomes.
• Early identification and monitoring of cognitive changes are vital for stroke patient care.
• Interventions aimed at maintaining cognitive function may improve survival and reduce disability after stroke.