Abstract
This study aimed to evaluate the effect of a newly designed intensive caregiver education program (ICEP) on reducing cognitive impairment, anxiety, and depression in acute ischemic stroke (AIS) patients. One hundred and ninety-six AIS patients were divided into ICEP group and Control group in a 1:1 ratio using blocked randomization method. In the ICEP group, the caregivers received ICEP, while in the Control group caregivers received usual education and guidance. All patients received conventional rehabilitation treatment. Cognitive impairment (assessed by Mini Mental State Examination (MMSE) score and Montreal Cognitive Assessment (MoCA) score), anxiety (assessed by Hospital Anxiety and Depression Scale (HADS)-A score and Self-rating Anxiety Scale (SAS) score), and depression (assessed by HADS-D score and Self-rating Depression Scale (SDS) score) were assessed at baseline (M0), 3 months (M3), 6 months (M6), and 12 months (M12). Cognitive impairment score at M12 and cognitive impairment score change (M12–M0) were increased, while cognitive impairment rate at M12 was reduced in the ICEP group compared with the Control group. Anxiety score change (M12–M0), anxiety score at M12, and anxiety rate at M12 were decreased in the ICEP group compared with the Control group. Depression score change (M12–M0), depression score at M12, and depression rate at M12 were lower in the ICEP group compared with the Control group. Further subgroup analysis based on baseline features also provided similar results. In conclusion, ICEP effectively reduced cognitive impairment, anxiety, and depression in AIS patients.
Highlights
Stroke is the leading cause of mortality in the aged population and there are 2.5 million new stroke cases occurring in China annually [1,2]
All analyses were performed based on the ITT principle with the last observation carried forward (LOCF) method for the missing data, showing that intensive caregiver education program (ICEP) decreased cognitive impairment and reduced anxiety and depression in Acute ischemic stroke (AIS) patients
Most rehabilitation programs for cognitive impairment mainly focus on stroke patients instead of caregivers, and the education needs of caregivers often lack attention
Summary
Stroke is the leading cause of mortality in the aged population and there are 2.5 million new stroke cases occurring in China annually [1,2]. Acute ischemic stroke (AIS) is a major pathological type of stroke triggered by cerebral ischemia, which leads to the dysfunction and degeneration of brain vascular components [3]. The survival rate of AIS has been dramatically improved by some effective AIS therapies (including thrombolysis, endovascular revascularization, AIS reperfusion etc.), while the reduced mortality increases the number of post-stroke survivors who suffer from complications [2,4]. As a complication that affects above one-third of stroke patients, progressively worsens and is accompanied with neuropsychological problems including anxiety and depression [5]. Effective management to reduce cognitive impairment, depression, and anxiety in AIS patients is essential
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