Stroke occurring in patients with cognitive impairment or dementia

ABSTRACT One in six patients admitted for stroke was previously demented. These patients have less access to appropriate stroke care, although little is known about their optimal management. Objective To determine how pre-stroke cognitive impairment can be detected, its mechanism, and influence on...

Full description

Saved in:
Bibliographic Details
Main Authors: Solène Moulin, Didier Leys
Format: Article
Language:English
Published: Thieme Revinter Publicações
Series:Arquivos de Neuro-Psiquiatria
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2017000200009&lng=en&tlng=en
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850230973906550784
author Solène Moulin
Didier Leys
author_facet Solène Moulin
Didier Leys
author_sort Solène Moulin
collection DOAJ
description ABSTRACT One in six patients admitted for stroke was previously demented. These patients have less access to appropriate stroke care, although little is known about their optimal management. Objective To determine how pre-stroke cognitive impairment can be detected, its mechanism, and influence on outcome and management. Methods Literature search. Results (i) A systematic approach with the Informant Questionnaire of Cognitive Decline in the Elderly is recommended; (ii) Pre-stroke cognitive impairment may be due to brain lesions of vascular, degenerative, or mixed origin; (iii) Patients with pre-stroke dementia, have worse outcomes, more seizures, delirium, and depression, and higher mortality rates; they often need to be institutionalised after their stroke; (iv) Although the safety profile of treatment is not as good as that of cognitively normal patients, the risk:benefit ratio is in favour of treating these patients like others. Conclusion Patients with cognitive impairment who develop a stroke have worse outcomes, but should be treated like others.
format Article
id doaj-art-068a51c928bc42569c8b0ec7da68e5db
institution OA Journals
issn 1678-4227
language English
publisher Thieme Revinter Publicações
record_format Article
series Arquivos de Neuro-Psiquiatria
spelling doaj-art-068a51c928bc42569c8b0ec7da68e5db2025-08-20T02:03:42ZengThieme Revinter PublicaçõesArquivos de Neuro-Psiquiatria1678-422775211712110.1590/0004-282x20160187S0004-282X2017000200009Stroke occurring in patients with cognitive impairment or dementiaSolène MoulinDidier LeysABSTRACT One in six patients admitted for stroke was previously demented. These patients have less access to appropriate stroke care, although little is known about their optimal management. Objective To determine how pre-stroke cognitive impairment can be detected, its mechanism, and influence on outcome and management. Methods Literature search. Results (i) A systematic approach with the Informant Questionnaire of Cognitive Decline in the Elderly is recommended; (ii) Pre-stroke cognitive impairment may be due to brain lesions of vascular, degenerative, or mixed origin; (iii) Patients with pre-stroke dementia, have worse outcomes, more seizures, delirium, and depression, and higher mortality rates; they often need to be institutionalised after their stroke; (iv) Although the safety profile of treatment is not as good as that of cognitively normal patients, the risk:benefit ratio is in favour of treating these patients like others. Conclusion Patients with cognitive impairment who develop a stroke have worse outcomes, but should be treated like others.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2017000200009&lng=en&tlng=enacidente vascular cerebralinfarto cerebralhemorragia cerebraldemênciacomprometimento cognitivo leve
spellingShingle Solène Moulin
Didier Leys
Stroke occurring in patients with cognitive impairment or dementia
Arquivos de Neuro-Psiquiatria
acidente vascular cerebral
infarto cerebral
hemorragia cerebral
demência
comprometimento cognitivo leve
title Stroke occurring in patients with cognitive impairment or dementia
title_full Stroke occurring in patients with cognitive impairment or dementia
title_fullStr Stroke occurring in patients with cognitive impairment or dementia
title_full_unstemmed Stroke occurring in patients with cognitive impairment or dementia
title_short Stroke occurring in patients with cognitive impairment or dementia
title_sort stroke occurring in patients with cognitive impairment or dementia
topic acidente vascular cerebral
infarto cerebral
hemorragia cerebral
demência
comprometimento cognitivo leve
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2017000200009&lng=en&tlng=en
work_keys_str_mv AT solenemoulin strokeoccurringinpatientswithcognitiveimpairmentordementia
AT didierleys strokeoccurringinpatientswithcognitiveimpairmentordementia