11/8/2023 0 Comments Memory loss after stroke![]() ![]() Despite the frequency of memory and cognitive disturbance post stroke, the onus is on the stroke-survivor to approach their GP to access timely care. The focus tends to be on the management of vascular risk factors to nationally set targets with little to no focus on the cognitive sequelae post stroke. In the UK, once stroke-survivors are discharged from specialist follow-up, the task for secondary stroke prevention lies with the primary care team. Although there may be physical recovery, post-stroke dementia will remain a significant limiting factor for survivors unless we are able to identify patients at risk of dementia earlier to ensure they get adequate access to intervention and care. However, in addition to the immediate impacts of the stroke, there is also a relationship between a history of both incident and recurrent stroke with subsequent development of dementia ( 7). In particular, post-stroke memory problems can persist in 11% to 31% of individuals 1 year post stroke ( 6). Although physical recovery may be evident, ‘hidden’ deficits such as cognitive impairment may remain unresolved with evidence showing that 90% of patients report some level of cognitive difficulty ( 5). There have also been recent calls for stroke clinicians to increase attention towards the cognitive consequences often associated with stroke ( 3).Īfter a stroke, individuals report fear, lack of social confidence and loss of identity particularly in the early stages of stroke recovery ( 4). ![]() Post-stroke cognitive disturbances were listed in the top 10 among patients and carers in a priority-setting exercise ( 2). Following stroke, the individual will often not only deal with the physical impact of the stroke itself but also mental, cognitive and emotional sequelae. Stroke is known to be a leading cause of disability worldwide with population growth and ageing being the main drivers ( 1). There were a number of flaws in these studies, such as having very few people in them, and these could have affected our findings.Access to care, aging, caregivers, dementia, primary care, stroke Introduction The quality of the evidence ranged from very low (effect on outcomes that relate to everyday activities) to moderate (effect on self-reported memory problems, memory tests, and mood measures). ![]() There was no information about any harm caused to participants from taking part in cognitive rehabilitation. We found no evidence that cognitive rehabilitation improved people's independence in activities of daily living, mood, or quality of life. ![]() However, there was no evidence that the benefits persisted in the long term. This represents a small to moderate effect of the intervention in comparison to the control group. We found that people who received cognitive rehabilitation reported fewer memory problems in daily life immediately after treatment compared with the control groups. Some studies had a control group wherein people received their usual care, whereas in others individuals in the control groups were placed on a waiting list to receive cognitive rehabilitation. The control group included those who did not receive cognitive rehabilitation or received another form of treatment. In these studies, those who received the treatment were compared with a control group. Treatment lasted between two weeks and 10 weeks. In three studies treatment was provided in groups and in 10 studies treatment was provided individually. Participants received various types of memory retraining techniques, including training using computer programs and training in the use of memory aids, such as diaries or calendars. Seven trials were conducted with community participants, four with in-patients, and two with mixed community and in-patient samples. In this review, we included 13 studies with 514 participants. However, it is uncertain whether memory rehabilitation can improve people's memory problems, or whether it has an effect on mood, performance in everyday activities, or quality of life. Memory rehabilitation is a standard part of rehabilitation in many settings. Memory rehabilitation, a part of cognitive rehabilitation, is a therapeutic activity that may play a role in the recovery of memory functions, or in enabling the individual to adapt to the problems. The degree and kind of memory problems, mood changes, and performance of everyday activities can vary widely depending on many factors, including the location of the stroke in the brain, severity, age, and the previous health of the person experiencing a stroke. People often struggle with memory problems following stroke and this can lead to difficulties in everyday life. We reviewed the evidence for the effectiveness of cognitive rehabilitation for memory problems in people with stroke. ![]()
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