{"title":"Post-stroke cognitive impairment","authors":"Sandeep Ankolekar, M. Simoni","doi":"10.1093/med/9780198747499.003.0025","DOIUrl":"https://doi.org/10.1093/med/9780198747499.003.0025","url":null,"abstract":"‘Post-stroke cognitive impairment’ explores in great depth the burden of post-stroke cognitive impairment, its pathological substrates and clinical characteristics, the causes of these impairments, post-stroke dementia, and the risk factors implicated. The chapter examines common definitions (vascular cognitive impairment, vascular dementia, post-stroke cognitive impairment), the DSM-5 criteria (Diagnostic and Statistical Manual of Mental Disorders-5), ICD-10 criteria (International Classification of Diseases), NINDS-AIREN criteria (National Institute of Neurological Disorders and Stroke and the Association Internationale pour la Recherche et l’Enseignement en Neurosciences) for vascular dementia, and vascular mild cognitive impairment. The VASCOG (vascular cognitive disorder) criteria are also described. A pragmatic approach to investigations and various assessment scales, a description of important clinical trials, and the management of these disorders are also included.","PeriodicalId":196384,"journal":{"name":"Stroke in the Older Person","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132265262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Urinary incontinence after stroke","authors":"A. Hillarious, S. Munshi, R. Harwood","doi":"10.1093/med/9780198747499.003.0019","DOIUrl":"https://doi.org/10.1093/med/9780198747499.003.0019","url":null,"abstract":"‘Urinary incontinence after stroke’ explores the problem of urinary incontinence. It describes the different types of urinary incontinence with a focus on the types of incontinence prevalent after a stroke; the impact of this symptom complex on the psychological state of the patient, mortality, dependency, and institutionalization; the age related changes in the urinary tract; the epidemiology of post-stroke urinary incontinence, risk factors predisposing to it, assessment methods (including bedside assessments), management with identification of transient causes of incontinence, behavioural strategies, pharmacological therapy, treatment of comorbid conditions, and management in special situations. Urge incontinence, stress incontinence, incomplete emptying, functional incontinence, overflow incontinence, and lower urinary tract symptoms, are all discussed in the context of the pathophysiology and management of these conditions.","PeriodicalId":196384,"journal":{"name":"Stroke in the Older Person","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121245094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hypertension in older people","authors":"W. Sunman","doi":"10.1093/med/9780198747499.003.0024","DOIUrl":"https://doi.org/10.1093/med/9780198747499.003.0024","url":null,"abstract":"‘Hypertension in older people’ highlights the issues concerning ageism in the diagnosis and management of hypertension, the prevalence, future predictions, and its historical aspects. Stroke is a disease of old age. The average age of stroke patients passing through our stroke unit is 76 years, in common with other units in the United Kingdom. Trials examining only those patients under 80 years old are examining a skewed population, in which around 40% of patients have been excluded. The author examines several trials of blood pressure lowering in older people, age related changes in blood pressure, the importance of systolic versus diastolic hypertension, targets of blood pressure control, impact of frailty, dementia, and cognitive impairment, orthostatic hypotension, and diabetes. Post-stroke blood pressure management is discussed in greater detail along with a review of the important trials in this group of patients.","PeriodicalId":196384,"journal":{"name":"Stroke in the Older Person","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125896671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Discharge from hospital and early supported discharge","authors":"C. Gaynor","doi":"10.1093/med/9780198747499.003.0022","DOIUrl":"https://doi.org/10.1093/med/9780198747499.003.0022","url":null,"abstract":"‘Discharge from hospital and early supported discharge’ provides some useful guidance and outlines the issues that we encounter in facilitating effective discharge from hospital following a stroke. Hospital discharge is an important milestone in a stroke patient’s journey. It marks the end of the acute hospital episode, and the start of a new life living with and adjusting to their stroke and its sequelae. It can be a stressful time for patients and their carers, but careful and thorough discharge planning can help to ease the transition from hospital to home. The chapter explores the timing of discharge, models of care after discharge, early supported discharge, the evidence from SSNAP (Sentinel Stroke National Audit Programme) in the United Kingdom, the initiative of CLAHRC (Collaborative for Leadership in Applied Health Research and Care), guidance from the National Institute for Health and Care Excellence (NICE), institutionalization, role of capacity, role of IMCA (independent mental capacity advocate), communication with primary care, and follow-up after discharge from hospital.","PeriodicalId":196384,"journal":{"name":"Stroke in the Older Person","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123687245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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