Stroke: Hard on Brain Function

Stroke tied to long term mental decline

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) A stroke happens in an instant, and many who survive report that their brain never works like it once did. But these problems with memory and thinking ability may not just be the immediate aftermath.

A new study from the University of Michigan found that patients who experienced a stroke had an immediate decline in cognitive function and — over the years following the stroke — these declines continued.

“Our results suggest that stroke survivors also warrant monitoring for mounting cognitive impairment over the years after the event,” wrote lead study author Deborah A. Levine, MD, of the University of Michigan Medical School, and colleagues.

Cognitive decline is a major cause of disability in patients who survive a stroke. Patients with cognitive decline may have trouble with memory, decision-making and completing daily activities, such as driving.

But patients may be able to lower their risk for stroke. Sean Ruland, DO, a neurologist, stroke specialist and medical director of the Neurosciences Intensive Care Unit at Loyola University Medical Center, offered some advice to dailyRx News.

“The single most important thing an individual can do to reduce the risk of stroke is to control blood pressure through diet, exercise and, if necessary, medication,” Dr. Ruland said.

Dr. Levine and team looked at nearly US 24,000 patients without any cognitive impairment. All patients were 45 years old or older. Over the six-year study period, 515 of these patients experienced a stroke.

The researchers then compared the stroke survivor's pre- and post-stroke cognitive function over the study period.

According to Dr. Levine and team, cognitive functions typically decline slightly with age. However, those who experienced a stroke also experienced a faster decline.

These patients displayed problems with the ability to organize their thoughts and prioritize tasks. They also tended to find it difficult to manage time, make decisions and learn new things.

“As adults increasingly survive stroke, cases of post-stroke cognitive impairment will multiply," Dr. Levine and colleagues wrote. "Given that post-stroke cognitive impairment increases mortality, morbidity, and health care costs, health systems and payers will need to develop cost-effective systems of care that will best manage the long-term needs and cognitive problems of this increasing and vulnerable stroke survivor population.”

In a related editorial, Philip B. Gorelick, MD, and David Nyenhuis, PhD, of the Michigan State University College of Human Medicine, wrote, “Clinicians should remain alert for the presence of [stroke] because these findings may be [signals] of future major complications such as recurrent stroke, cognitive impairment, and disability.”

This study was published July 7 in the journal JAMA.

The National Institute of Neurological Disorders and Stroke, the National Institutes of Health and the US Department of Health and Human Services funded this research.

Dr. Levine disclosed receiving a grant from the National Institute on Aging and fees from the pharmaceutical company AstraZeneca. AstraZeneca makes medications used in the prevention and treatment of stroke.

No conflicts of interest were disclosed.

Review Date: 
July 6, 2015
Last Updated:
July 15, 2015