What are the correlates of cognition and participation to return to work after first ever mild stroke?

Fride, Y.; Adamit, Tal; Maeir, Adina; Assayag, Einor Ben; Bornstein, Nathan M.; Korczyn, Amos D.; Katz, Noomi

doi:10.1179/1074935714z.0000000013

Cited by 107 publications

(80 citation statements)

References 55 publications

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“…Research and interventions have historically focused on physical disabilities [2], while cognitive impairment – an important aspect for stroke survivors – has been rather neglected [3, 4]. Even minor stroke affects daily functioning, executive functions, and cognition, consequently affecting participation, quality of life, and return to work [5]. Stroke survivors are at increased risk of developing cognitive impairment.…”

Section: Introductionmentioning

confidence: 99%

Post-stroke dementia – a comprehensive review

Mijajlović

Pavlović

Brainin

et al. 2017

BMC Med

536

411

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Post-stroke dementia (PSD) or post-stroke cognitive impairment (PSCI) may affect up to one third of stroke survivors. Various definitions of PSCI and PSD have been described. We propose PSD as a label for any dementia following stroke in temporal relation. Various tools are available to screen and assess cognition, with few PSD-specific instruments. Choice will depend on purpose of assessment, with differing instruments needed for brief screening (e.g., Montreal Cognitive Assessment) or diagnostic formulation (e.g., NINDS VCI battery). A comprehensive evaluation should include assessment of pre-stroke cognition (e.g., using Informant Questionnaire for Cognitive Decline in the Elderly), mood (e.g., using Hospital Anxiety and Depression Scale), and functional consequences of cognitive impairments (e.g., using modified Rankin Scale). A large number of biomarkers for PSD, including indicators for genetic polymorphisms, biomarkers in the cerebrospinal fluid and in the serum, inflammatory mediators, and peripheral microRNA profiles have been proposed. Currently, no specific biomarkers have been proven to robustly discriminate vulnerable patients (‘at risk brains’) from those with better prognosis or to discriminate Alzheimer’s disease dementia from PSD. Further, neuroimaging is an important diagnostic tool in PSD. The role of computerized tomography is limited to demonstrating type and location of the underlying primary lesion and indicating atrophy and severe white matter changes. Magnetic resonance imaging is the key neuroimaging modality and has high sensitivity and specificity for detecting pathological changes, including small vessel disease. Advanced multi-modal imaging includes diffusion tensor imaging for fiber tracking, by which changes in networks can be detected. Quantitative imaging of cerebral blood flow and metabolism by positron emission tomography can differentiate between vascular dementia and degenerative dementia and show the interaction between vascular and metabolic changes. Additionally, inflammatory changes after ischemia in the brain can be detected, which may play a role together with amyloid deposition in the development of PSD. Prevention of PSD can be achieved by prevention of stroke. As treatment strategies to inhibit the development and mitigate the course of PSD, lowering of blood pressure, statins, neuroprotective drugs, and anti-inflammatory agents have all been studied without convincing evidence of efficacy. Lifestyle interventions, physical activity, and cognitive training have been recently tested, but large controlled trials are still missing.

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Section: Introductionmentioning

confidence: 99%

Post-stroke dementia – a comprehensive review

Mijajlović

Pavlović

Brainin

et al. 2017

BMC Med

536

411

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“…Even after a minor stroke with no disabling impairment, stroke has an impact on individuals’ daily life (Adamit et al, 2015; Fride et al, 2015; Taule et al, 2015). Not only survivors have to deal with the emotional charge of having experienced a stroke but living after the accident involves many adjustments in life habits in the short, middle and long terms (Salter et al, 2008; Peoples et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Combining Standard Conventional Measures and Ecological Momentary Assessment of Depression, Anxiety and Coping Using Smartphone Application in Minor Stroke Population: A Longitudinal Study Protocol

et al. 2017

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Context: Stroke has several consequences on survivors’ daily life even for those who experience short-lasting neurological symptoms with no functional disability. Depression and anxiety are common psychological disorders occurring after a stroke. They affect long-term outcomes and quality of life but they are difficult to diagnose because of the neurobiological consequences of brain lesions. Current research priority is given to the improvement of the detection and prevention of those post-stroke psychological disorders. Although previous studies have brought promising perspectives, their designs based on retrospective tools involve some limits regarding their ecological validity. Ecological Momentary Assessment (EMA) is an alternative to conventional instruments that could be a key in research for understanding processes that underlined post-stroke depression and anxiety onset. We aim to evaluate the feasibility and validity of anxiety, depression and coping EMA for minor stroke patients.Methods: Patients hospitalized in an Intensive Neuro-vascular Care Unit between April 2016 and January 2017 for a minor stroke is involved in a study based on an EMA methodology. We use a smartphone application in order to assess anxiety and depression symptoms and coping strategies four times a day during 1 week at three different times after stroke (hospital discharge, 2 and 4 months). Participants’ self-reports and clinician-rates of anxiety, depression and coping are collected simultaneously using conventional and standard instruments. Feasibility of the EMA method will be assessed considering the participation and compliance rate. Validity will be the assessed by comparing EMA and conventional self-report and clinician-rated measures.Discussion: We expect this study to contribute to the development of EMA using smartphone in minor stroke population. EMA method offers promising research perspective in the assessment and understanding of post-stroke psychological disorders. The development of EMA in stroke population could lead to clinical implications such as remotely psychological follow-ups during early supported discharge.Trial registration: European Clinical Trials Database Number 2014-A01937-40

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“…Individuals who survive a more severe stroke often undergo extensive multidisciplinary rehabilitation in an inpatient setting. By contrast, patients who have a minor stroke are likely to be discharged home early, often with limited referrals to services beyond their general practitioner 3 . This is despite increasing evidence that survivors of minor stroke may have persisting stroke‐related impairments that require rehabilitation 4 .…”

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confidence: 99%

“…By contrast, patients who have a minor stroke are likely to be discharged home early, often with limited referrals to services beyond their general practitioner. 3 This is despite increasing evidence that survivors of minor stroke may have persisting strokerelated impairments that require rehabilitation. 4 These "hidden" impairments may not become apparent until after discharge, when the patient attempts to resume their usual daily activities.…”

mentioning

confidence: 99%