Long-Term Cognitive Decline After Stroke: An Individual Participant Data Meta-Analysis

Area of Science:

• Neurology
• Neuroscience
• Cognitive Science

Background:

• Poststroke cognitive impairment is a significant concern, yet its long-term trajectory remains poorly understood.
• Understanding cognitive change patterns after stroke is crucial for effective management and intervention.

Purpose of the Study:

• To investigate the course and determinants of cognitive change following stroke.
• To compare cognitive decline rates in stroke survivors versus stroke-free individuals.

Main Methods:

• Individual participant data meta-analysis of nine longitudinal cohorts from seven countries.
• Standardized cognitive scores were calculated for global cognition and five domains.
• Analyses focused on the period from 1-year poststroke to assess long-term effects, comparing stroke patients with stroke-free controls.

Main Results:

• Global cognition and most cognitive domains declined after the first year poststroke (-0.053 SD/year).
• Older age and recurrent stroke were linked to accelerated cognitive decline.
• Cognitive decline was significantly faster in stroke patients than in controls (-0.078 SD/year difference).

Conclusions:

• Stroke survivors experience faster cognitive decline than stroke-free individuals from 1 to 3 years poststroke.
• Older age and recurrent stroke are key risk factors for accelerated cognitive decline after stroke.