Deans' stroke musings: The Impact of Cognitive Impairment on Poststroke Outcomes: A 5-Year Follow-Up

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, June 11, 2019

The Impact of Cognitive Impairment on Poststroke Outcomes: A 5-Year Follow-Up

What this means is that the first thing your doctor has to have is a protocol for recovering the lost 5 cognitive years from your stroke.

Because if you can't follow and research how to recover yourself you will be screwed since your doctor has zero stroke rehab protocols that get you anywhere close to 100% recovery. Your doctor doesn't know one damn thing about stroke recovery. For proof ask what prescriptions were written to OT, PT, ST. If E.T.(Evaluate and Treat) then your doctor knows nothing about stroke.

The Impact of Cognitive Impairment on Poststroke Outcomes: A 5-Year Follow-Up

Show all authors

Daniela Rohde, MSc

, Eva Gaynor, MD, Margaret Large, BSc, ...

First Published June 5, 2019 Research Article

Article Information

Article first published online: June 5, 2019
Received: February 12, 2019; Revisions received: April 04, 2019; Accepted: April 15, 2019

Daniela Rohde, MSc¹, Eva Gaynor, MD², Margaret Large, BSc³, Lisa Mellon, PhD¹, Patricia Hall, MSc³, Linda Brewer, MD⁴, Kathleen Bennett, PhD¹, David Williams, PhD⁴, Eamon Dolan, MRCP⁵, Elizabeth Callaly, MD⁶, Anne Hickey, PhD¹

¹Population Health Sciences, RCSI, Dublin, Ireland

²Department of Medicine, RCSI, Dublin, Ireland

³Clinical Research Centre, Beaumont Hospital, Dublin, Ireland

⁴Geriatric and Stroke Medicine, RCSI and Beaumont Hospital, Dublin, Ireland

⁵Geriatric Medicine, Connolly Hospital Blanchardstown, Dublin, Ireland

⁶Geriatric Medicine, Mater Misericordiae University Hospital, Dublin, Ireland

Corresponding Author:

Daniela Rohde, Division of Population Health Sciences, Royal College of Surgeons in Ireland, Beaux Lane House, Lower Mercer St, Dublin 2, Ireland. Email: danielamrohde@rcsi.ie

Abstract

Aim:

To explore the impact of cognitive impairment poststroke on outcomes at 5 years.

Methods:

Five-year follow-up of the Action on Secondary Prevention Interventions and Rehabilitation in Stroke (ASPIRE-S) prospective cohort. Two hundred twenty-six ischemic stroke survivors completed Montreal Cognitive Assessments at 6 months poststroke. Outcomes at 5 years included independence in activities of daily living, receipt of informal care, quality of life, and depressive symptoms. Data were analyzed using logistic and linear regression models. Adjusted odds ratios (ORs; 95% confidence interval [CI]) and β coefficients (95% CI) are reported.

Results:

One hundred one stroke survivors were followed up at 5 years. Cognitive impairment at 6 months was independently associated with worse quality of life (B [95% CI]: −0.595 [−0.943 to −0.248]), lower levels of independence (B [95% CI]: −3.605 [−5.705 to −1.505]), increased likelihood of receiving informal care (OR [95% CI]: 6.41 [1.50-27.32]), and increased likelihood of depressive symptoms (OR [95% CI]: 4.60 [1.22-17.40]). Conclusion: Cognitive impairment poststroke is associated with a range of worse outcomes. More effective interventions are needed to improve outcomes for this vulnerable group of patients.

Keywords cerebrovascular disorders, stroke, cognitive impairment, independence, activities of daily living, depression, quality of life