title: Predictors of Vascular Cognitive Impairment Poststroke in a Middle Eastern (Bahrain) Cohort: A Proposed Case-Control Comparison.
abstract: BACKGROUND
  Poststroke dementia and cognitive impairment are associated with poor long-term outcomes after stroke. The contribution of genetic factors such as the presence of apolipoprotein (ApoE) ɛ4 allele and its association with cognitive impairment poststroke remains inconclusive, particularly in Middle Eastern regions.
  
  
  OBJECTIVE
  The aim of this study is to examine all correlates and potential predictors of cognitive impairment including self-awareness and regulation deficits in stroke patients and compare these functions with healthy older adults from a Middle Eastern population.
  
  
  METHODS
  A prospective stroke sample of 200 patients (case group) and 100 healthy aging individuals (control group) will be recruited from the largest medical complex in Bahrain. A neuropsychological battery of cognitive assessments (global, executive, and metacognition) will be conducted on all participants. Participants will be categorized into 4 subgroups (nonvascular cognitive impairment, vascular cognitive impairment with no dementia, vascular dementia, and mixed dementia) using standardized cognitive assessment scores and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, dementia criteria. Biomarkers will include ApoE genotype, soluble form of receptor for advanced glycation end products, neprilysin, beta-secretase 1, biochemistry, and hematology measurements.
  
  
  RESULTS
  The primary study outcome is to determine early risk factors for cognitive impairment after stroke in a Bahraini cohort. The study has received full ethical approval from the Bahrain Ministry of Health and from the affiliated university.
  
  
  CONCLUSIONS
  With increasing stroke incidence rates in the Middle East, this research study will provide useful biological and epidemiological data for future development and planning of health policies and guidelines for stroke care within the Gulf region.
authors.affiliation: School of Nursing and Midwifery, Faculty of Health Sciences, University of Dublin, Trinity College, Dublin, Ireland.
authors.forename: Claire
authors.identifier: http://orcid.org/0000-0002-9226-9407
authors.initials: C
authors.lastname: Donnellan
authors.affiliation: Department of Clinical Neurosciences, Salmaniya Medical Complex, Salmaniya, Bahrain.
authors.forename: Mona
authors.identifier: http://orcid.org/0000-0003-0513-1838
authors.initials: M
authors.lastname: Al Banna
authors.affiliation: Department of Clinical Neurosciences, Salmaniya Medical Complex, Salmaniya, Bahrain.
authors.forename: Noor
authors.initials: N
authors.lastname: Redha
authors.affiliation: Department of Clinical Neurosciences, Salmaniya Medical Complex, Salmaniya, Bahrain.
authors.forename: Adel
authors.identifier: http://orcid.org/0000-0003-0702-8869
authors.initials: A
authors.lastname: Al Jishi
authors.affiliation: Department of Clinical Neurosciences, Salmaniya Medical Complex, Salmaniya, Bahrain.
authors.forename: Isa
authors.initials: I
authors.lastname: Al Sharoqi
authors.affiliation: Department of Molecular Medicine, Princess Al Jawhara Center for Genetics and Inherited Diseases, Salmaniya, Bahrain.
authors.forename: Safa
authors.initials: S
authors.lastname: Taha
authors.affiliation: Department of Molecular Medicine, Princess Al Jawhara Center for Genetics and Inherited Diseases, Salmaniya, Bahrain.
authors.forename: Moiz
authors.identifier: http://orcid.org/0000-0002-5148-8849
authors.initials: M
authors.lastname: Bakhiet
authors.affiliation: Department of Clinical Neurosciences, Salmaniya Medical Complex, Salmaniya, Bahrain.
authors.forename: Fatema
authors.identifier: http://orcid.org/0000-0003-4679-3387
authors.initials: F
authors.lastname: Abdulla
authors.affiliation: School of Medicine, Royal College of Surgeons in Ireland-Bahrain, Busaiteen, Bahrain.
authors.forename: Patrick
authors.identifier: http://orcid.org/0000-0003-0726-6488
authors.initials: P
authors.lastname: Walsh
keywords: assessment; biomarkers; cognition; protocol; stroke; vascular dementia