Wrong objective. It should have been how do you rebuild cognitive reserve to prepare for your likely dementia? EXACT PROTOCOLS are required to do that, not useless guidelines or guesses.
Your doctor is responsible for having EXACT PROTOCOLS to rebuild your cognitive reserve to prepare you to successfully survive your upcoming dementia. I probably used up all my cognitive reserve surviving my stroke as well as I did.
Your risk of dementia, has your doctor told you of this?
1. A documented 33% dementia chance post-stroke from an Australian study? May 2012.
2. Then this study came out and seems to have a range from 17-66%. December 2013.`
3. A 20% chance in this research. July 2013.
4. Dementia Risk Doubled in Patients Following Stroke September 2018
The latest here:
Role of cognitive reserve in ischemic stroke prognosis: A systematic review
Chunhua Tao1,2†, 
Yuan Yuan2,3†, 
Yijun Xu4, 
Song Zhang5, Zheng Wang2, Sican Wang2, Jingyan Liang6,7 and 
Yingge Wang1*- 1Department of Neurology, Affiliated Hospital of Yangzhou University, Yangzhou, China
- 2School of Nursing and School of Public Health, Yangzhou University, Yangzhou, China
- 3Division of Satoyama Nursing and Telecare, Nagano College of Nursing, Komagane, Japan
- 4Department of the Advanced Biomedical Research, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo, Japan
- 5Department of Biomedical Science and Institute of Bioscience and Biotechnology, Kangwon National University, Chuncheon-si, Gangwon-do, Republic of Korea
- 6Department of Anatomy, Medical College, Yangzhou University, Yangzhou, China
- 7Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou, China
Objective: This systematic review was performed to identify the role of cognitive reserve (CR) proxies in the functional outcome and mortality prognostication of patients after acute ischemic stroke.
Methods: PubMed, Embase, Web of Science, and Cochrane Library were comprehensively searched by two independent reviewers from their inception to 31 August 2022, with no restrictions on language. The reference lists of reviews or included articles were also searched. Cohort studies with a follow-up period of ≥3 months identifying the association between CR indicators and the post-stroke functional outcome and mortality were included. The outcome records for patients with hemorrhage and ischemic stroke not reported separately were excluded. The Quality In Prognosis Studies (QUIPS) tool was used to assess the quality of included studies.
Results: Our search yielded 28 studies (n = 1,14,212) between 2004 and 2022, of which 14 were prospective cohort studies and 14 were retrospective cohort studies. The follow-up period ranged from 3 months to 36 years, and the mean or median age varied from 39.6 to 77.2 years. Of the 28 studies, 15 studies used the functional outcome as their primary outcome interest, and 11 of the 28 studies included the end-point interest of mortality after ischemic stroke. In addition, two of the 28 studies focused on the interest of functional outcomes and mortality. Among the included studies, CR proxies were measured by education, income, occupation, premorbid intelligence quotient, bilingualism, and socioeconomic status, respectively. The quality of the review studies was affected by low to high risk of bias.
Conclusion: Based on the current literature, patients with ischemic stroke with higher CR proxies may have a lower risk of adverse outcomes. Further prospective studies involving a combination of CR proxies and residuals of fMRI measurements are warranted to determine the contribution of CR to the adverse outcome of ischemic stroke.
Systematic review registration: PROSPERO, identifier CRD42022332810, https://www.crd.york.ac.uk/PROSPERO/.
Introduction
It is well established that stroke is one of the leading causes of death and long-term disability worldwide among adults (1). Especially, older patients aged ≥75 years are at an increased risk of suffering from stroke during the last decades of their life (2), which imposes an enormous burden on global public health (3). Among stroke survivors, they were more likely to present significant deficits in multiple domains, including motor and cognitive impairment, disability, and psychological disorders (4, 5). Previous studies demonstrated that the first 3 months after ischemic stroke is a critical period of recovery, followed by a stable stage (6, 7). Although numerous studies have been conducted to predict adverse clinical and functional outcomes after ischemic stroke (8–10), further studies are essential to understand the underlying factors of inter-individual heterogeneity that contributed to unfavorable stroke outcomes. The term conserve reserve (CR) was theoretically constructed to explain the inter-individual discrepancies between the severity of brain pathology and clinical manifestations (11). A consensus was reached on the definition of CR in a recent whitepaper, defining CR as an active model of reserve acquired from various lifetime experiences (i.e., education attainment, intellectual activity, occupation history, and other environmental factors) via shaping the brain's network efficiency, processing capacity, and flexibility to protect against brain aging, pathology, or brain insult (12, 13). As measuring CR directly is full of challenges, sociobehavioral proxy indicators are commonly used to indirectly estimate CR, including education, occupation, leisure activities, premorbid intelligence quotient (IQ), socioeconomic status (SES), and/or bilingualism (14).
The concept of CR is well validated in patients with stroke as the study has found that the degree of cognitive impairment varied widely among individuals, despite comparable levels of pathology (13). An increasing number of studies have been carried out to examine the effects of potential CR proxies on the prediction and recovery of cognitive impairment after stroke (15–17). Previous studies provided some indication that CR may act as a crucial role in stroke recovery (17). Nevertheless, recent reviews or original studies focused only on the effect of educational attainment as an indicator of CR on post-stroke cognition, neglecting other functional stroke outcomes (i.e., disability, psychological disorders, and motor impairment) (16, 18). To the best of our knowledge, no systematic review or meta-analysis was conducted to methodically summarize the impact of CR sociobehavioral proxies on post-stroke functional outcomes and mortality.
To comprehensively assess the impact of CR sociobehavioral proxies on ischemic stroke outcomes, we performed a systematic review to identify the association of CR proxies with stroke outcomes, taking inter-individual variability into consideration.
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