title: Stroke occurring in patients with cognitive impairment or dementia.
abstract: OBJECTIVE
  To determine how pre-stroke cognitive impairment can be detected, its mechanism, and influence on outcome and management.
  
  
  METHODS
  Literature search.
  
  
  RESULTS
  (i) A systematic approach with the Informant Questionnaire of Cognitive Decline in the Elderly is recommended; (ii) Pre-stroke cognitive impairment may be due to brain lesions of vascular, degenerative, or mixed origin; (iii) Patients with pre-stroke dementia, have worse outcomes, more seizures, delirium, and depression, and higher mortality rates; they often need to be institutionalised after their stroke; (iv) Although the safety profile of treatment is not as good as that of cognitively normal patients, the risk:benefit ratio is in favour of treating these patients like others.
  
  
  CONCLUSIONS
  Patients with cognitive impairment who develop a stroke have worse outcomes, but should be treated like others.
authors.affiliation: Université de Lille. INSERM U 1171, Troubles cognitifs dégénératifs et vasculaires. CHU de Lille, Service de Neurologie, Lille, France.
authors.forename: Solène
authors.initials: S
authors.lastname: Moulin
authors.affiliation: Université de Lille. INSERM U 1171, Troubles cognitifs dégénératifs et vasculaires. CHU de Lille, Service de Neurologie, Lille, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Leys
mesh_terms: D003072:Cognition Disorders / Q000150:complications*; D003704:Dementia / Q000150:complications*; D006801:Humans; D011379:Prognosis; D012307:Risk Factors; D020521:Stroke / Q000150:complications*