title: Secondary prevention and cognitive function after stroke: a study protocol for a 5-year follow-up of the ASPIRE-S cohort.
abstract: Cognitive impairment is common following stroke and can increase disability and levels of dependency of patients, potentially leading to greater burden on carers and the healthcare system. Effective cardiovascular risk factor control through secondary preventive medications may reduce the risk of cognitive decline. However, adherence to medications is often poor and can be adversely affected by cognitive deficits. Suboptimal medication adherence negatively impacts secondary prevention targets, increasing the risk of recurrent stroke and further cognitive decline. The aim of this study is to profile cognitive function and secondary prevention, including adherence to secondary preventive medications and healthcare usage, 5 years post-stroke. The prospective associations between cognition, cardiovascular risk factors, adherence to secondary preventive medications, and rates of recurrent stroke or other cardiovascular events will also be explored.
  
  
  
  This is a 5-year follow-up of a prospective study of the Action on Secondary Prevention Interventions and Rehabilitation in Stroke (ASPIRE-S) cohort of patients with stroke. This cohort will have a detailed assessment of cognitive function, adherence to secondary preventive medications and cardiovascular risk factor control.
  
  
  
  Ethical approval for this study was granted by the Research Ethics Committees at Beaumont Hospital, Dublin and Connolly Hospital, Dublin, Mater Misericordiae University Hospital, Dublin, and the Royal College of Surgeons in Ireland. Findings will be disseminated through presentations and peer-reviewed publications.
authors.affiliation: Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.
authors.forename: Daniela
authors.identifier: 0000-0001-8834-2539
authors.initials: D
authors.lastname: Rohde
authors.affiliation: Department of Geriatric and Stroke Medicine, Royal College of Surgeons in Ireland and Beaumont Hospital, Dublin, Ireland.
authors.forename: David
authors.initials: D
authors.lastname: Williams
authors.affiliation: Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland.
authors.forename: Eva
authors.initials: E
authors.lastname: Gaynor
authors.affiliation: Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Bennett
authors.affiliation: Department of Geriatric Medicine, Connolly Hospital Blanchardstown, Dublin, Ireland.
authors.forename: Eamon
authors.initials: E
authors.lastname: Dolan
authors.affiliation: Department of Geriatric Medicine, Mater Misericordiae University Hospital, Dublin, Ireland.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Callaly
authors.affiliation: Clinical Research Centre, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.
authors.forename: Margaret
authors.initials: M
authors.lastname: Large
authors.affiliation: Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.
authors.forename: Anne
authors.initials: A
authors.lastname: Hickey
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D003072:Cognition Disorders / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007494:Ireland; D008297:Male; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods; D020521:Stroke / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D017741:Survivors; D016903:Drug Monitoring
chemical_list: D000925:Anticoagulants; D000959:Antihypertensive Agents
keywords: cardiovascular risk factors; medication adherence; secondary prevention