Effect of post-stroke cognitive impairment and dementia on stroke recurrence and functional outcomes: A systematic review and meta-analysis.

<h4>Introduction</h4>Post-stroke cognitive impairment (PSCI) and dementia may have a significant impact on stroke recurrence and long-term functional outcomes of patients.<h4>Aim</h4>To investigate the potential link between PSCI and dementia, and stroke recurrence, mortality...

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Main Authors: Jia Yu, Jie Wang
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0313633&type=printable
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author Jia Yu
Jie Wang
author_facet Jia Yu
Jie Wang
author_sort Jia Yu
collection DOAJ
description <h4>Introduction</h4>Post-stroke cognitive impairment (PSCI) and dementia may have a significant impact on stroke recurrence and long-term functional outcomes of patients.<h4>Aim</h4>To investigate the potential link between PSCI and dementia, and stroke recurrence, mortality, and poor functional outcomes of stroke survivors.<h4>Methods</h4>A systematic search across Medline, Google Scholar, and Science Direct databases was done for studies that evaluated the association of PSCI and dementia with long-term stroke outcomes. The results were expressed as pooled hazard ratios (HR) with 95% confidence intervals (CI), and heterogeneity was assessed using the I2 statistic and the Chi-square test. Subgroup analyses were performed based on the sample size, geographical location, follow-up, and type of dementia/cognitive impairment. Study quality was evaluated using the Newcastle Ottawa Scale (NOS).<h4>Results</h4>The meta-analysis included thirteen studies. Of them, ten studies (n = 4036) reported a significant association between PSCI and stroke recurrence, with a pooled HR of 1.33 (95% CI: 1.14-1.55, I2 = 84.6%). Subgroup analysis revealed a statistically significant association between PSCI and stroke recurrence across various subrgoups. Four studies (n = 1944) demonstrated that patients with PSCI had a higher risk of poor functional outcome, with a pooled HR of 1.68 (95% CI: 1.16-2.05, I2 = 80.0%). However, the multivariate analysis did not detect a significant association between PSCI and stroke mortality, with a pooled HR of 1.50 (95% CI: 0.94-2.40, I2 = 45.9%).<h4>Conclusions</h4>The study showed that PSCI was associated with 33% increased stroke recurrence and 68% higher rate of poor functional outcome. Our findings underscore the adverse impact of PSCI on stroke recurrence and functional outcomes, emphasizing the importance of early detection and targeted interventions to mitigate the cognitive impairment burden in stroke survivors.
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spelling doaj-art-545b60757ef64aeaa342b5779580014b2024-12-18T05:31:38ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-011912e031363310.1371/journal.pone.0313633Effect of post-stroke cognitive impairment and dementia on stroke recurrence and functional outcomes: A systematic review and meta-analysis.Jia YuJie Wang<h4>Introduction</h4>Post-stroke cognitive impairment (PSCI) and dementia may have a significant impact on stroke recurrence and long-term functional outcomes of patients.<h4>Aim</h4>To investigate the potential link between PSCI and dementia, and stroke recurrence, mortality, and poor functional outcomes of stroke survivors.<h4>Methods</h4>A systematic search across Medline, Google Scholar, and Science Direct databases was done for studies that evaluated the association of PSCI and dementia with long-term stroke outcomes. The results were expressed as pooled hazard ratios (HR) with 95% confidence intervals (CI), and heterogeneity was assessed using the I2 statistic and the Chi-square test. Subgroup analyses were performed based on the sample size, geographical location, follow-up, and type of dementia/cognitive impairment. Study quality was evaluated using the Newcastle Ottawa Scale (NOS).<h4>Results</h4>The meta-analysis included thirteen studies. Of them, ten studies (n = 4036) reported a significant association between PSCI and stroke recurrence, with a pooled HR of 1.33 (95% CI: 1.14-1.55, I2 = 84.6%). Subgroup analysis revealed a statistically significant association between PSCI and stroke recurrence across various subrgoups. Four studies (n = 1944) demonstrated that patients with PSCI had a higher risk of poor functional outcome, with a pooled HR of 1.68 (95% CI: 1.16-2.05, I2 = 80.0%). However, the multivariate analysis did not detect a significant association between PSCI and stroke mortality, with a pooled HR of 1.50 (95% CI: 0.94-2.40, I2 = 45.9%).<h4>Conclusions</h4>The study showed that PSCI was associated with 33% increased stroke recurrence and 68% higher rate of poor functional outcome. Our findings underscore the adverse impact of PSCI on stroke recurrence and functional outcomes, emphasizing the importance of early detection and targeted interventions to mitigate the cognitive impairment burden in stroke survivors.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0313633&type=printable
spellingShingle Jia Yu
Jie Wang
Effect of post-stroke cognitive impairment and dementia on stroke recurrence and functional outcomes: A systematic review and meta-analysis.
PLoS ONE
title Effect of post-stroke cognitive impairment and dementia on stroke recurrence and functional outcomes: A systematic review and meta-analysis.
title_full Effect of post-stroke cognitive impairment and dementia on stroke recurrence and functional outcomes: A systematic review and meta-analysis.
title_fullStr Effect of post-stroke cognitive impairment and dementia on stroke recurrence and functional outcomes: A systematic review and meta-analysis.
title_full_unstemmed Effect of post-stroke cognitive impairment and dementia on stroke recurrence and functional outcomes: A systematic review and meta-analysis.
title_short Effect of post-stroke cognitive impairment and dementia on stroke recurrence and functional outcomes: A systematic review and meta-analysis.
title_sort effect of post stroke cognitive impairment and dementia on stroke recurrence and functional outcomes a systematic review and meta analysis
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0313633&type=printable
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AT jiewang effectofpoststrokecognitiveimpairmentanddementiaonstrokerecurrenceandfunctionaloutcomesasystematicreviewandmetaanalysis