In spite of my doctor doing nothing for my cognition or physical effects of the stroke I actually feel smarter and more focused post-stroke. A likely outlier, one of those who should be studied to see why and how to replicate. What is your doctor doing to measure and document your cognitive status and decline? Mine did nothing.
Scientists from the University of Michigan have found that preventing a stroke keeps your mind 8 years younger and sharper.
http://www.ncbi.nlm.nih.gov/pubmed/26151265
- 1Department
of Internal Medicine, University of Michigan Medical School, Ann
Arbor2Veterans Affairs Center for Clinical Management Research, Ann
Arbor, Michigan3Institute for Healthcare Policy and Innovation,
University of Michigan, Ann Arbor4Department of.
- 2Department
of Internal Medicine, University of Michigan Medical School, Ann
Arbor5Department of Biostatistics, University of Michigan, Ann Arbor.
- 3Department
of Internal Medicine, University of Michigan Medical School, Ann
Arbor2Veterans Affairs Center for Clinical Management Research, Ann
Arbor, Michigan3Institute for Healthcare Policy and Innovation,
University of Michigan, Ann Arbor6Institute for.
- 4Department of Psychiatry, Indiana University of School of Medicine, Indianapolis.
- 5Department
of Internal Medicine, University of Michigan Medical School, Ann
Arbor2Veterans Affairs Center for Clinical Management Research, Ann
Arbor, Michigan.
- 6Department of Psychiatry, University of Michigan Medical School, Ann Arbor.
- 7Department of Medicine, University of Alabama at Birmingham School of Medicine.
Abstract
IMPORTANCE:
Cognitive
decline is a major cause of disability in stroke survivors. The
magnitude of survivors' cognitive changes after stroke is uncertain.
OBJECTIVE:
To
measure changes in cognitive function among survivors of incident
stroke, controlling for their prestroke cognitive trajectories.
DESIGN, SETTING, AND PARTICIPANTS:
Prospective
study of 23,572 participants 45 years or older without baseline
cognitive impairment from the Reasons for Geographic and Racial
Differences in Stroke (REGARDS) cohort, residing in the continental
United States, enrolled 2003-2007 and followed up through March 31,
2013. Over a median follow-up of 6.1 years (interquartile range, 5.0-7.1
years), 515 participants survived expert-adjudicated incident stroke
and 23,057 remained stroke free.
EXPOSURE:
Time-dependent incident stroke.
MAIN OUTCOMES AND MEASURES:
The
primary outcome was change in global cognition (Six-Item Screener
[SIS], range, 0-6). Secondary outcomes were change in new learning
(Consortium to Establish a Registry for Alzheimer Disease Word-List
Learning; range, 0-30), verbal memory (Word-List Delayed Recall; range,
0-10), and executive function (Animal Fluency Test; range, ≥0), and
cognitive impairment (SIS score <5 [impaired] vs ≥5 [unimpaired]).
For all tests, higher scores indicate better performance.
RESULTS:
Stroke
was associated with acute decline in global cognition (0.10 points [95%
CI, 0.04 to 0.17]), new learning (1.80 points [95% CI, 0.73 to 2.86]),
and verbal memory (0.60 points [95% CI, 0.13 to 1.07]). Participants
with stroke, compared with those without stroke, demonstrated faster
declines in global cognition (0.06 points per year faster [95% CI, 0.03
to 0.08]) and executive function (0.63 points per year faster [95% CI,
0.12 to 1.15]), but not in new learning and verbal memory, compared with
prestroke slopes. Among survivors, the difference in risk of cognitive
impairment acutely after stroke, compared with immediately before
stroke, was not statistically significant (odds ratio, 1.32 [95% CI,
0.95 to 1.83]; P = .10); however, there was a significantly faster
poststroke rate of incident cognitive impairment compared with the
prestroke rate (odds ratio, 1.23 per year [95% CI, 1.10 to 1.38];
P < .001). For a 70-year-old black woman with average values for all
covariates at baseline, stroke at year 3 was associated with greater
incident cognitive impairment: absolute difference of 4.0% (95% CI,
-1.2% to 9.2%) at year 3 and 12.4% (95% CI, 7.7% to 17.1%) at year 6.
CONCLUSIONS AND RELEVANCE:
Incident
stroke was associated with an acute decline in cognitive function and
also accelerated and persistent cognitive decline over 6 years.
While my cognitive abilities were pathetic immediately after the stroke, my husband says I've recovered a lot, but am still not as smart as I used to be. I did correctly factor a simple quadratic equation a few days after having a stroke, and I've improved a lot since then, but I'm still not smart enough, in his opinion?
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