Newswise — WASHINGTON (September 21, 2022) - In patients with post-stroke cognitive impairment, the risk factors that contribute to stroke recurrence or death in certain populations is still unknown. A better understanding of who is at risk for a stroke recurrence or death would allow clinicians to better identify, monitor and treat stroke patients at a higher risk, which could potentially prevent stroke recurrence and save lives.
A study published in the Journal of Stroke and Cerebrovascular Diseases performed a secondary analysis on stroke patients with insulin resistance – a known risk factor for stroke– to see if cognitive impairment increased the risk of a stroke recurrence or death. The patients were part of the National Institute of Neurological Disorders and Stroke’s NIH Insulin Resistance Intervention After Stroke Trial.
The study, conducted by Zurab Nadareishvili, corresponding author and associate professor in the GW University Department of Neurology and Rehabilitation and his colleagues, found that impaired language was associated with a 35% increased risk of stroke recurrence, and orientation impairment was associated with a 41% increase in stroke recurrence. The researchers also found that impaired attention was associated with a 34% increase in risk of all-cause mortality. All these associations were independent of demographics, vascular risk factors, stroke cause and severity, as well as treatment including study drug assignment.
“This research highlights the importance of cognitive testing of patients around 3 months after stroke to better identify those at higher risk of stroke recurrence and death,” said Dr. Nadareishvili. “Further research is needed to better understand how these cognitive impairments increase the risk of stroke, and more work should be done to better identify how to best treat patients at a higher risk.”
In addition to Dr. Nadareishvili, Kat Schmidt, previously a master’s student in GW’s Milken School for Public Health, was lead author on the paper. Other members of the research team included Adam Ciarleglio, assistant professor of biostatistics in GW’s Milken Institute School of Public Health, and Melinda Power, associate professor of epidemiology and director of the GW Institute for Brain Health and Dementia. Nadareishvili and Ciarleglio are senior authors of the paper.
The study, “Post-stroke cognitive impairment and the risk of stroke recurrence and death in patients with insulin resistance,” was published in the Journal of Stroke and Cerebrovascular Diseases.