Elderly care old and young
An international study spearheaded by researchers in Sydney has developed a “simple, practical tool” that could significantly aid in predicting the risk of dementia in stroke survivors. This tool utilizes routinely collected clinical data to forecast a person’s likelihood of developing dementia within five years following a stroke, presenting a crucial opportunity for early intervention.
The study, conducted by the University of New South Wales (UNSW) and published in the Neurology journal, analyzed data from over 2,600 stroke survivors across 12 studies in 10 countries, including regions in Asia, Australia, Africa, Europe, and the United States. This research is part of the global Stroke and Cognition Consortium (STROKOG) and aims to create a reliable model for dementia risk prediction.
Understanding the Predictive Tool
Participants in the study had a mean age of 67 years and were monitored for a median period of two years. During this time, 655 individuals developed dementia. The researchers discovered that a combination of simple factors such as age, sex, education, stroke severity, diabetes, and history of prior strokes could accurately estimate a stroke survivor’s risk of developing dementia within five years when applied to an Excel-based calculator.
Lead author Jess Lo, from the UNSW Centre for Healthy Brain Ageing (CHeBA), highlighted that while most post-stroke care focuses on physical recovery, cognitive changes, which can be equally disabling, are often overlooked. Up to 60% of stroke survivors experience some cognitive impairment within the first year after a stroke, and nearly one in three will develop dementia within five years.
“Early detection is key,” said Ms. Lo. “If we can identify people at highest risk, we can intervene earlier, adapt care plans, and potentially delay progression to dementia.”
Implications for Healthcare and Policy
The tool, currently available to Neurology subscribers for download, offers a promising avenue for healthcare professionals to identify patients at high risk and prioritize cognitive monitoring, early intervention, and support. Dr. Marita Long, a GP with a special interest in dementia and honorary medical advisor for Dementia Australia, emphasized the importance of integrating cognitive assessments into stroke recovery care.
“We’ve got to be mindful that there’s only so many tools we can use,” Dr. Long told newsGP. “But I think whatever can help to reinforce addressing well-established risk factors for dementia, we should be incorporating this into our care.”
Dr. Long also noted that while tools can be helpful, healthcare providers should always consider established dementia risk factors and maintain a low threshold for comprehensive cognitive assessments for patients with concerns.
Future Prospects and Challenges
Senior author and Co-Director of CHeBA, Professor Perminder Sachdev, acknowledged that while the tool shows promise, further validation is necessary before it can be recommended for routine clinical use. However, he pointed out its potential to inform health policy and resource planning, such as aiding GPs in prioritizing follow-up cognitive assessments for patients identified as high-risk by the tool.
“Screening for cognitive impairment in stroke patients is currently recommended, but it is often not implemented due to limited resources,” Professor Sachdev said. “This tool enables stroke clinicians to quickly estimate a patient’s five-year risk of developing dementia.”
Dr. Long highlighted the growing role of GPs in addressing cognitive decline in stroke survivors, noting the increasing need for general practice to diagnose dementia due to an aging population and a shortage of specialists.
“GPs are gaining confidence and becoming much more proactive in performing cognitive assessments,” she said. “When you’re caring for patients post-stroke, you’ve got to be thinking of so many things – secondary prevention, the physical recovery, returning to driving and work – so cognitive decline is another issue to add into the mix.”
The development of this tool marks a significant step forward in post-stroke care, potentially improving the quality of life for stroke survivors and their families by facilitating earlier interventions and better resource allocation.
