Post-Stroke Cognitive Disorders

Vascular cognitive impairment is the current term that reflects the range of cognitive deficits due to the impact of cerebrovascular disease, including stroke. According to the Canadian Study of Health and Aging (2000), it is estimated that 5% of all people over the age of 65 years have evidence of vascular cognitive impairment. The risk for cognitive impairment or decline is augmented by a history of stroke. As many as two-thirds of patients experience cognitive impairment or decline following stroke and approximately one third develop dementia. Risk for developing dementia may be up to 10 times greater among individuals with stroke than for those without. In this review, we examine issues regarding the definition, prevalence, and natural history of post-stroke cognitive impairment as well as its clinical consequences. Risk factors for cognitive impairment as related to demographics, atherosclerosis, and stroke are explored. Treatment interventions are identified, including: cognitive rehabilitation strategies for remediation of deficits in attention, memory, executive function, and problem solving; nerve and brain stimulation; exercise programs; music listening; and pharmacotherapy. The impact, risk factors, clinical consequences, and treatment of delirium following stroke are also reviewed.