Abstract
In this review, we aimed to identify the risk factors that may influence cognitive impairment among stroke survivors, namely, demographic, clinical, psychological, and physical determinants. A search from Medline, Scopus, and ISI Web of Science databases was conducted for papers published from year 2004 to 2015 related to risk factors of cognitive impairment among adult stroke survivors. A total of 1931 articles were retrieved, but only 27 articles met the criteria and were reviewed. In more than half of the articles it was found that demographical variables that include age, education level, and history of stroke were significant risk factors of cognitive impairment among stroke survivors. The review also indicated that diabetes mellitus, hypertension, types of stroke and affected region of brain, and stroke characteristics (e.g., size and location of infarctions) were clinical determinants that affected cognitive status. In addition, the presence of emotional disturbances mainly depressive symptoms showed significant effects on cognition. Independent relationships between cognition and functional impairment were also identified as determinants in a few studies. This review provided information on the possible risk factors of cognitive impairment in stroke survivors. This information may be beneficial in the prevention and management strategy of cognitive impairments among stroke survivors.
Highlights
It has been reported that approximately 15 to 30% of stroke survivors live with permanent disability [1]
Seven studies predicted the influence of physical functioning on cognitive impairment among stroke survivors [35, 36, 39,40,41, 45, 46]
It is deduced that stroke survivors with higher education level were less likely to be affected in their cognitive functioning because they have larger brain reserve capacity which can compensate for the brain damage [62]
Summary
It has been reported that approximately 15 to 30% of stroke survivors live with permanent disability [1]. Previous literature reviews predominantly explain vascular risk factors and mechanisms of cognitive impairments [12, 13], impact and treatment options for cognitive impairment [14], and interaction of vascular risk factors with stroke [15], and overlooked or little emphasis was given on the psychological and physical determinants. This may be due to difference in studied variables, methodologies, and outcome measurements. Exercise is advocated to heighten cognitive function among stroke survivors [19]
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