Prevention of post-stroke cognitive decline: a review focusing on lifestyle interventions.
OBJECTIVE
Despite a high prevalence of post-stroke cognitive impairment, therapeutic possibilities are still limited. Stroke and dementia share the same cluster of modifiable risk factors. Thus, lifestyle interventions and strict adherence to medication may not only decrease the risk of recurrent stroke but also the risk of post-stroke cognitive decline.


METHODS
We performed a systematic literature search for randomized clinical trials (RCTs) targeting modifiable risk factors for the prevention of cognitive decline following stroke.


RESULTS
We identified 25 non-pharmacological interventions and eight multiple risk factor interventions in stroke patients using cognition as outcome measure. None of the published trials investigated interventions aimed at the prevention of post-stroke cognitive decline. However, a number of ongoing trials aim at risk factor reduction and include measures on cognition.


CONCLUSIONS
Evidence for risk factor modification for the prevention of cognitive decline after stroke is scarce and comes mainly from observational studies. There is a need for more RCTs targeting the prevention of post-stroke dementia using lifestyle interventions and a multiple risk factor approach.
Department for Clinical Neurosciences and Preventive Medicine, Danube University Krems, Krems, Austria.
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Y
Teuschl
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Matz
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Brainin
D003072:Cognition Disorders / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D016208:Databases, Factual / Q000706:statistics & numerical data; D006801:Humans; D008019:Life Style; D016032:Randomized Controlled Trials as Topic; D020521:Stroke / Q000150:complications* / Q000628:therapy*