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Cited by 539Dementia and Cognitive Impairment ResearchNeurological Disease Mechanisms and TreatmentsStroke Rehabilitation and Recovery

Cognitive Impairment After Ischemic and Hemorrhagic Stroke: A Scientific Statement From the American Heart Association/American Stroke Association

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El Husseini, Nada, Katzan, Irene L., Rost, Natalia S., Blake, Margaret Lehman, Byun, Eeeseung, Pendlebury, Sarah T., Aparicio, Hugo J., Marquine, María J. +3 more·2023·Stroke
DOI 10.1161/str.0000000000000430PMC PMC12723706
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Abstract

Purpose: Cognitive impairment is a common consequence of stroke and has direct implications for poststroke functioning and quality of life, including the ability to maintain a job, live independently, sustain interpersonal relationships, and drive a vehicle. In this scientific statement, we critically appraise the literature on the prevalence, diagnosis, and management of poststroke cognitive impairment (PSCI) and provide a framework for clinical care while highlighting gaps that merit further study. Methods: We performed a scoping literature review of randomized controlled clinical trials, prospective and retrospective cohort studies, case-control studies, clinical guidelines, review articles, and editorials on the incidence and prevalence, natural history, diagnosis, and management of PSCI. Scoping reviews determine the scope of a body of literature on a given topic to indicate the volume of literature and the studies currently available and provide an overview of its focus. Results: PSCI is common after stroke, especially in the first year, and ranges from mild to severe. Although cognitive impairment is reversible in some cases early after stroke, up to one-third of individuals with stroke develop dementia within 5 years. The pathophysiology is not yet fully elucidated but is likely attributable to an acute stroke precipitating a series of pathological events, often in the setting of preexisting microvascular and neurodegenerative changes. Screening for associated comorbidities and interdisciplinary management are integral components of the care of individuals with PSCI. There is a need for prospective studies evaluating the individual trajectory of PSCI and the role of the acute vascular event in the predisposition for Alzheimer disease and related dementias, as well as high-quality, randomized clinical trials focused on PSCI management.

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  • Numerous studies recommend using plain language instead of complicated medical terminologies when communicating with patients about their health.

    “Numerous studies recommend using plain language instead of complicated medical terminologies when communicating with patients about their health [20, 21].”

    From A Data Visualization Tool for Patients and Healthcare Providers to Communicate during Inpatient Stroke Rehabilitation (2024) · cites this paper as [21]

    The Management of post-stroke cognitive impairment section discusses treating communication deficits after stroke, and Anticipatory guidance for patients and their caregivers discusses matters clinicians should address. Neither recommends plain language over medical terminology when explaining health information to patients. Searches for “plain language” and “medical jargon” found no passage addressing that recommendation. (LLM, conf=0.72)

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Cited by

Sorted by citations

Authors
El Husseini, N., Katzan, I. L., Rost, N. S., Blake, M. L., Byun, E., Pendlebury, S. T., Aparicio, H. J., Marquine, M. J., Gottesman, R. F., Smith, E. E., & on behalf of the American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Radiology and Intervention; Council on Hypertension; and Council on Lifestyle and Cardiometabolic Health
ORCID
Venue
Stroke
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2023-06
Volume
54
Issue
6
Pages
e272-e291
ISSN
  • 0039-2499 (ISSN-L)
  • 1524-4628
DOI
10.1161/str.0000000000000430
PMC
PMC12723706
OpenAlex
W4367601115
Cited by
539
References
17
Citations by year
2026: 202 · 2025: 207 · 2024: 105 · 2023: 25
FWCI
24.61
Type
journal article
Language
en
Open access
Locations
  • Stroke (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institute on Aging (K24AG075240)
  • National Institute of Nursing Research (K23NR017404)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
  • Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
Keywords
post-stroke cognitive impairment, ischemic stroke, hemorrhagic stroke, prevalence, diagnosis, Alzheimer's disease, neurodegeneration, microvascular changes, comorbidity screening, multidisciplinary care, natural history (disease)
MeSH terms
Hemorrhagic Stroke, American Heart Association, Humans, Prospective Studies, Quality of Life, Retrospective Studies, Stroke, Cognitive Dysfunction

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