Faster medical intervention key for lessening memory loss in stroke patients
Click Here to Manage Email Alerts
Rapid intensive care, including endovascular therapy after stroke, proved to be a factor in less memory loss, according to results of a survey published in the American Academy of Neurology.
“Cohort studies worldwide have suggested that following stroke there is cognitive decline affecting verbal memory, verbal fluency, temporal orientation, processing speed, executive function and global cognition over time,” Wentian Lu, PhD, from the research department of epidemiology and public health at the University College London, and colleagues wrote.
“However, the exact timing of the association remains unclear. Several cohort studies have estimated cognitive transitions before and after first stroke; the results were mixed, perhaps due to disparities in cognitive measures.”
Researchers sought to investigate the significance of timing in memory change following stroke as prior research and evidence was limited and inconsistent. The survey tracked memory trajectories in 35,164 participants from 18 European nations to assess whether acute care in these countries displayed a positive impact on memory change after stroke.
Data were collected from a 15-year-long Survey of Health, Ageing and Retirement between 2004 and 2019. Incident first and recurrent strokes were identified among baseline stroke-free individuals. For each country one participant who had experienced a stroke was paired with one who had not suffered one previously. Then, researchers used multilevel segmented linear regression to quantify both short-term and rapid memory alterations after a series of word recall tests before and after cases of initial and recurring strokes in both groups. Comparisons were made between nations that provided varied levels of acute stroke care indications, then associations between stroke incidence and effort on memory were drawn.
The final analytical sample included participants who had not previously suffered a stroke at the predetermined baseline age of at least 50 years old. From that group, 2,362 initial and 341 recurrent strokes during the time frame of the survey were identified. Results showed that in the former group of those who had suffered a stroke, short-term decreases in memory loss were observed. Conversely, no short-term reductions were found in the latter group. Further analysis uncovered that in both survey groups, rates of memory function decline were similar. Average scores for those who suffered initial or recurring stroke were lower than in those with better access to treatment
From these data, researchers determined that greater effort should be placed on assessment and prevention of stroke, while promoting access to and delivery of acute care, including stroke unit care, intravenous thrombolysis and endovascular treatment (EVT).
“We found acute decreases in memory after incident first and recurrent strokes in comparison to matched stroke-free individuals, whereas memory decline rates were similar. These associations were independent of a wide range of potential confounders,” Lu and colleagues wrote.
“Acute memory decreases were smaller in countries with moderate-to-high levels of EVT care, suggesting that improved EVT might be associated with smaller memory loss after stroke.”