Global cognitive function before, surrounding, and after ischemic stroke: the role of risk and protective factors varies with time among ischemic stroke survivors

Abstract

An estimated 65% of individuals demonstrate multi-domain cognitive impairment post-stroke, although little is known about the varying role of cognitive risk and protective factors in pre-, peri-, and post-ischemic stroke phases. Longitudinal changes in global cognitive function after ischemic stroke are not well characterized, especially in older adults over age 80. We examined global cognitive function trajectories in these three phases across a mean follow-up of 8.12 (2.30) years in 159 female stroke survivors aged 65–79 at baseline using linear mixed models with change points. In separate models controlling for demographic variables, we tested the interaction of baseline risk and protective factors with stroke phase on global cognitive function. None of the pre-stroke global cognitive function means or trajectories differed significantly. At the time of ischemic stroke, higher body mass index, the presence of hypertension, low optimism, and higher physical function were all associated with significantly greater mean decreases in global cognition (all p’s <.0.0001), but were not significantly different from the contrasting level (all p’s > 0.05). Higher body mass index, the presence of hypertension, low optimism, and higher physical function were in turn protective of global cognitive decline post- ischemic stroke (all contrasting p values <.01). Baseline factors may play either a risk or a protective role in global cognitive function depending on the phase of ischemic stroke.

Protective Effect of Dimethyl Fumarate on Memory Impairment After Cerebral Ischemia-Reperfusion Injury in Rats

“…Learning and memory impairments represent the pathogenic advancement of the damage induced by cerebral ischemia/reperfusion. Such damages could lead to disabilities and restriction in social activities (3,15). In our study, we have seen a progress in learning behaviors in rats treated with DMF compared to control group, 7 days after the induction of ischemia by Morris water maze test.…”

“…Ischemic brain injury is one of the most important causes of disability and mortality in adults worldwide that results from cerebral circulatory arrest (1,2). Transient global cerebral ischemia (TGCI) can cause cognitive, behavioral, learning and memory impairments (2,3). Characterized mechanisms of post-TGCI neuronal damage consist of diminished blood flow to the brain, mitochondrial damage, free radical development, destruction of membrane, injury to the blood vessels, prevention of protein synthesis, inflammation, brain edema formation and finally delayed neuronal death of the CA1 zone of the hippocampus (4).…”

Cognitive improvement following ischemia/reperfusion injury induced by voluntary running‑wheel exercise is associated with LncMALAT1‑mediated apoptosis inhibition

“…The pathological condition of cerebral ischemia is responsible for learning and memory impairments, and adversely affects the everyday and social lives of survivors ( 25 ). The present study revealed that I/R injury may lead to significant neurological loss, learning and memory deficits, which is consistent with previous findings ( 4 , 26 ).…”

The neuroprotective mechanisms of ginkgolides and bilobalide in cerebral ischemic injury: a literature review

“…In the acute phase of ischemic strokes, declines in cognitive efficiency in domains including executive function, immediate recall, delayed recall, speech, divergent thinking, attention and concentration, and visual-constructive performance have been observed (Bugarski Ignjatovic et al 2015). Body mass index, hypertension, low optimism, and physical function have also been associated with a decrease in global cognition (Vaughan et al 2016). Furthermore, serum oxLDL levels and enlarged perivascular spaces were also associated with cognitive impairment in patients that suffered ischemic strokes (Wang et al 2018b, Arba et al 2018).…”