Cognitive outcomes following ischaemic stroke: a narrative review

Aging and health research Pub Date : 2025-05-05 DOI:10.1016/j.ahr.2025.100232

Jananee Myooran , Faiyaz Rahman , Dennis Cordato , Danielle Ní Chróinín

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Abstract

Background

Cognitive impairment is a common sequela of ischaemic stroke, especially in older patients who are often predisposed to both delirium and dementia. Despite this, factors associated with cognitive impairment post-stroke are poorly evaluated in everyday clinical practice, including associated risk factors, the impact of reperfusion therapies on risk of post-stroke cognitive impairment, and effects on mortality and morbidity.

Methods

A literature review was conducted, using PubMed and EMBASE databases. 62 articles were included in the review.

Results

The review demonstrated several risk factors for cognitive impairment in patients with ischaemic stroke. Patient related factors include age, race, atrial fibrillation, diabetes and pre-stroke cognition. Stroke-related factors include extensive, multi-territorial infarcts. Only endovascular thrombectomy improved cognitive outcomes post stroke. Post stroke cognitive impairment is associated with greater risk of institutionalization, depression, delirium, stroke recurrence and mortality.

Conclusion

Moving forward, utilizing cognition as a primary outcome in trials, as well as exploring the impact of post-stroke cognition on patients is essential. Therefore, further research is required to delineate the relationship between ischaemic stroke and post-stroke cognitive impairment.

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缺血性中风后的认知结果：一项叙述性回顾

认知障碍是缺血性脑卒中的常见后遗症，特别是在老年患者中，他们往往易患谵妄和痴呆。尽管如此，在日常临床实践中，与脑卒中后认知功能障碍相关的因素，包括相关危险因素、再灌注治疗对脑卒中后认知功能障碍风险的影响以及对死亡率和发病率的影响，都没有得到很好的评估。方法采用PubMed和EMBASE数据库进行文献综述。本综述共纳入62篇文章。结果本综述揭示了缺血性脑卒中患者认知功能障碍的几个危险因素。患者相关因素包括年龄、种族、心房颤动、糖尿病和卒中前认知。卒中相关因素包括广泛的、多区域的梗死。只有血管内血栓切除术能改善脑卒中后的认知预后。卒中后认知障碍与更大的住院、抑郁、谵妄、卒中复发和死亡风险相关。展望未来，将认知作为试验的主要结果，并探索脑卒中后认知对患者的影响是必要的。因此，缺血性脑卒中与脑卒中后认知障碍之间的关系有待进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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