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Stroke injury, cognitive impairment and vascular dementia.
Biochim Biophys Acta 2016; 1862(5):915-25BB

Abstract

The global burden of ischaemic strokes is almost 4-fold greater than haemorrhagic strokes. Current evidence suggests that 25-30% of ischaemic stroke survivors develop immediate or delayed vascular cognitive impairment (VCI) or vascular dementia (VaD). Dementia after stroke injury may encompass all types of cognitive disorders. States of cognitive dysfunction before the index stroke are described under the umbrella of pre-stroke dementia, which may entail vascular changes as well as insidious neurodegenerative processes. Risk factors for cognitive impairment and dementia after stroke are multifactorial including older age, family history, genetic variants, low educational status, vascular comorbidities, prior transient ischaemic attack or recurrent stroke and depressive illness. Neuroimaging determinants of dementia after stroke comprise silent brain infarcts, white matter changes, lacunar infarcts and medial temporal lobe atrophy. Until recently, the neuropathology of dementia after stroke was poorly defined. Most of post-stroke dementia is consistent with VaD involving multiple substrates. Microinfarction, microvascular changes related to blood-brain barrier damage, focal neuronal atrophy and low burden of co-existing neurodegenerative pathology appear key substrates of dementia after stroke injury. The elucidation of mechanisms of dementia after stroke injury will enable establishment of effective strategy for symptomatic relief and prevention. Controlling vascular disease risk factors is essential to reduce the burden of cognitive dysfunction after stroke. This article is part of a Special Issue entitled: Vascular Contributions to Cognitive Impairment and Dementia edited by M. Paul Murphy, Roderick A. Corriveau and Donna M. Wilcock.

Authors+Show Affiliations

Institute of Neuroscience, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, NE4 5PL, United Kingdom; Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Nigeria; Department of Stroke and Cerebrovascular Diseases, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan. Electronic address: r.n.kalaria@ncl.ac.uk.Institute of Neuroscience, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, NE4 5PL, United Kingdom; Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Nigeria; Department of Stroke and Cerebrovascular Diseases, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan.Institute of Neuroscience, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, NE4 5PL, United Kingdom; Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Nigeria; Department of Stroke and Cerebrovascular Diseases, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

26806700

Citation

Kalaria, Raj N., et al. "Stroke Injury, Cognitive Impairment and Vascular Dementia." Biochimica Et Biophysica Acta, vol. 1862, no. 5, 2016, pp. 915-25.
Kalaria RN, Akinyemi R, Ihara M. Stroke injury, cognitive impairment and vascular dementia. Biochim Biophys Acta. 2016;1862(5):915-25.
Kalaria, R. N., Akinyemi, R., & Ihara, M. (2016). Stroke injury, cognitive impairment and vascular dementia. Biochimica Et Biophysica Acta, 1862(5), pp. 915-25. doi:10.1016/j.bbadis.2016.01.015.
Kalaria RN, Akinyemi R, Ihara M. Stroke Injury, Cognitive Impairment and Vascular Dementia. Biochim Biophys Acta. 2016;1862(5):915-25. PubMed PMID: 26806700.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Stroke injury, cognitive impairment and vascular dementia. AU - Kalaria,Raj N, AU - Akinyemi,Rufus, AU - Ihara,Masafumi, Y1 - 2016/01/22/ PY - 2015/11/11/received PY - 2016/01/18/revised PY - 2016/01/20/accepted PY - 2016/1/26/entrez PY - 2016/1/26/pubmed PY - 2019/1/25/medline KW - Alzheimer's disease KW - Cognitive impairment KW - Dementia KW - Microinfarcts KW - Neuroimaging KW - Post-stroke dementia KW - Stroke KW - Vascular dementia KW - White matter SP - 915 EP - 25 JF - Biochimica et biophysica acta JO - Biochim. Biophys. Acta VL - 1862 IS - 5 N2 - The global burden of ischaemic strokes is almost 4-fold greater than haemorrhagic strokes. Current evidence suggests that 25-30% of ischaemic stroke survivors develop immediate or delayed vascular cognitive impairment (VCI) or vascular dementia (VaD). Dementia after stroke injury may encompass all types of cognitive disorders. States of cognitive dysfunction before the index stroke are described under the umbrella of pre-stroke dementia, which may entail vascular changes as well as insidious neurodegenerative processes. Risk factors for cognitive impairment and dementia after stroke are multifactorial including older age, family history, genetic variants, low educational status, vascular comorbidities, prior transient ischaemic attack or recurrent stroke and depressive illness. Neuroimaging determinants of dementia after stroke comprise silent brain infarcts, white matter changes, lacunar infarcts and medial temporal lobe atrophy. Until recently, the neuropathology of dementia after stroke was poorly defined. Most of post-stroke dementia is consistent with VaD involving multiple substrates. Microinfarction, microvascular changes related to blood-brain barrier damage, focal neuronal atrophy and low burden of co-existing neurodegenerative pathology appear key substrates of dementia after stroke injury. The elucidation of mechanisms of dementia after stroke injury will enable establishment of effective strategy for symptomatic relief and prevention. Controlling vascular disease risk factors is essential to reduce the burden of cognitive dysfunction after stroke. This article is part of a Special Issue entitled: Vascular Contributions to Cognitive Impairment and Dementia edited by M. Paul Murphy, Roderick A. Corriveau and Donna M. Wilcock. SN - 0006-3002 UR - https://www.unboundmedicine.com/medline/citation/26806700/Stroke_injury_cognitive_impairment_and_vascular_dementia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0925-4439(16)30002-3 DB - PRIME DP - Unbound Medicine ER -