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RESEARCH PRODUCT
Cognitive impairment and stroke in elderly patients.
Corrao SalvatoreGianluca LopezDaniele Lo Cocosubject
Preventive Health ServiceGerontologylcsh:Diseases of the circulatory (Cardiovascular) systemAgingEndocrinology Diabetes and MetabolismDiseaseReview0302 clinical medicineCognitionRisk FactorsPreventive Health ServicesPrevalenceMedicineAge FactorPharmacology (medical)030212 general & internal medicineCognitive declineStrokeAged 80 and overAge FactorsCognitionHematologyGeneral MedicinePrognosiscerebrovascular diseaseStrokeCardiology and Cardiovascular MedicineRisk assessmentHumanPrognosielderlyRisk AssessmentVascular risk factorAging; Cerebrovascular disease; Cognitive function; Dementia; Vascular risk factors; Age Factors; Aged; Aged 80 and over; Aging; Cognition Disorders; Geriatric Assessment; Humans; Prevalence; Preventive Health Services; Prognosis; Quality of Life; Risk Assessment; Risk Factors; Stroke; Cognition; Cardiology and Cardiovascular Medicine; Pharmacology (medical); Public Health Environmental and Occupational Health; Hematology; Endocrinology Diabetes and MetabolismCognition Disorder03 medical and health sciencesDementiaHumansCognitive rehabilitation therapyVascular dementiaGeriatric Assessmentcognitive functioncognitive impairmentAgedbusiness.industryRisk FactorPublic Health Environmental and Occupational Healthmedicine.diseaselcsh:RC666-701vascular risk factorsQuality of LifebusinessCognition Disorders030217 neurology & neurosurgerydementiadescription
Daniele Lo Coco,1 Gianluca Lopez,1 Salvatore Corrao,2,31Neurology and Stroke Unit, 2Department of Internal Medicine, National Relevance and High Specialization Hospital Trust ARNAS Civico, Di Cristina, Benfratelli, Palermo, 3Centre of Research for Effectiveness and Appropriateness in Medicine (C.R.E.A.M.), Di.Bi.M.I.S., University of Palermo, Palermo, Italy Abstract: We reviewed current knowledge about the interaction between stroke and vascular risk factors and the development of cognitive impairment and dementia. Stroke is increasingly recognized as an important cause of cognitive problems and has been implicated in the development of both Alzheimer's disease and vascular dementia. The prevalence of cognitive impairment after stroke is high, and their combined effects significantly increase the cost of care and health resource utilization, with reflections on hospital readmissions and increased mortality rates. There is also substantial evidence that vascular risk factors (such as hypertension, diabetes, obesity, dyslipidemia, and tobacco smoking) are independently associated with an increased risk of cognitive decline and dementia. Thus, a successful management of these factors, as well as optimal acute stroke management, might have a great impact on the development of cognitive impairment. Notwithstanding, the pathological link between cognitive impairment, stroke, and vascular risk factors is complex and still partially unclear so that further studies are needed to better elucidate the boundaries of this relationship. Many specific pharmacological treatments, including anticholinergic drugs and antihypertensive medications, and nonpharmacological approaches, such as diet, cognitive rehabilitation, and physical activity, have been studied for patients with vascular cognitive impairment, but the optimal care is still far away. Meanwhile, according to the most recent knowledge, optimal stroke care should also include cognitive assessment in the short and long term, and great efforts should be oriented toward a multidisciplinary approach, including quality-of-life assessment and support of caregivers. Keywords: cerebrovascular disease, dementia, vascular risk factors, cognitive function, aging
year | journal | country | edition | language |
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2016-03-01 | Vascular health and risk management |