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, November 16, 2021

Aspirin Flops Again for Dementia Prevention

With your good chance of getting dementia your doctor should have EXACT DEMENTIA PREVENTION PROTOCOLS  already set up. If not, you don't have a competent doctor.

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:

 

Aspirin Flops Again for Dementia Prevention

ASCEND trial sides with ASPREE, but can't rule out some potential benefit

Affirming the ASPREE trial findings, daily aspirin failed to turn up a significant impact on dementia and cognitive function in an analysis of the ASCEND trial, but the analysis was unable to rule out a modest effect.

Among the some 15,000 diabetes patients in ASCEND, dementia was no less common for those randomized to aspirin or placebo, whether defined narrowly (3.3% vs 3.7%, respectively; RR 0.89, 95% CI 0.75-1.06) or broadly to also include cognitive impairment, delirium or confusion, use of dementia medications, and referral to a memory clinic or geriatric psychiatry (7.1% vs 7.8%; RR 0.91, 95% CI 0.81-1.02).

Cognitive scores were nearly identical between the two arms, Jane Armitage, MBBS, of the University of Oxford in England, reported at the virtual American Heart Association (AHA) meeting.

Still, the trial suggested little chance of cognitive harm from aspirin, but a plausible benefit in the 15-18% range, she said.

A 15% reduction in risk would be clinically relevant, noted AHA press conference moderator Christie Ballantyne, MD, of Baylor College of Medicine in Houston.

"Trials with larger numbers of incident dementia cases are needed to assess whether such benefits actually exist," Armitage concluded, although predicting that such trials would need to be roughly twice as large as ASCEND.

ASCEND was "really consistent" with the ASPREE trial's finding that daily use of aspirin in healthy adults over the age of 70 did not reduce dementia, mild cognitive impairment, or cognitive decline, noted Erin Michos, MD, MHS, of the Johns Hopkins School of Medicine and School of Public Health in Baltimore, who served as study discussant at the AHA press conference.

Main trial results from ASCEND had shown a reduction in major cardiovascular events with aspirin use, but an increase in major bleeding, such that there was no group for whom the benefits would clearly outweigh the risks, Armitage said when presenting those findings in 2018.

Looking at the dementia findings in context, Michos suggested that the best strategy may be to prevent cardiovascular events that have been tied to dementia through blood pressure and lipid control, cessation of smoking, and lifestyle measures. "Those might be more effective ways to prevent atherosclerotic cardiovascular disease and subsequently prevent dementia," she said.

And since studies have suggested midlife cardiovascular health strongly predicts later life cognition and dementia, Michos added, "as a prevention strategy, we need much more focus on improving the cardiovascular health of the population much earlier in life."

She cautioned, though, that U.S. Preventive Services Task Force draft recommendations against primary prevention aspirin use for older adults do not apply to those with established cardiovascular disease or prior events. American College of Cardiology/AHA guidelines also suggest only selective primary prevention use.

ASCEND included 15,480 patients in the U.K. who were age 40 or older and had any type of diabetes but no prior cardiovascular disease. They were randomized to 100-mg aspirin daily or placebo, and in a separate portion of the trial to either omega-3 fatty acids or placebo. Patients were followed for a mean 7.4 years on study drug and 1.8 years afterward through electronic medical records and hospital admissions.

Analyses were restricted to the 15,427 participants without any indication of dementia at baseline. Cognitive function testing done via telephone or online was available for 9,015 participants.

Disclosures

ASCEND was funded by the British Heart Foundation, U.K. Medical Research Council, and Alzheimer's Research U.K., with some support from Bayer for aspirin, Abbott, Mylan, and Solvay.

Armitage disclosed no personal financial relationships with industry.

 

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