title: Clinical trials for preventing post stroke cognitive impairment.
abstract: Post stroke dementia (PSD) develops in up to 40% of patients and often co-exists with Alzheimer's disease in the elderly. Unsurprisingly, the combination of stroke and dementia is associated with considerable morbidity and mortality, and is devastating to patients and carers. Limited trial evidence suggests that lowering high blood pressure reduces the development of cognitive decline, vascular dementia and PSD, although whether this relates to the magnitude of BP reduction or specific drug classes remains unclear. Biological plausibility and/or existing studies suggest that other types of drug treatments might also be effective, including choline esterase inhibitors, lipid lowering agents, antiplatelet agents, and selective serotonin reuptake inhibitors. Preventing cognitive decline and dementia post stroke is critical and large definitive trials are now needed.
authors.affiliation: Stroke Trials Unit, University of Nottingham, Nottingham NG5 1PB, UK.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Ankolekar
authors.forename: Chamila
authors.initials: C
authors.lastname: Geeganage
authors.forename: Peter
authors.initials: P
authors.lastname: Anderton
authors.forename: Cheryl
authors.initials: C
authors.lastname: Hogg
authors.forename: Philip M W
authors.initials: PM
authors.lastname: Bath
mesh_terms: D002986:Clinical Trials as Topic; D003072:Cognition Disorders / Q000209:etiology / Q000517:prevention & control*; D003704:Dementia / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D055502:Secondary Prevention; D020521:Stroke / Q000150:complications*