Cognitive impairment and risk of future stroke: a systematic review and meta-analysis
Several studies have assessed the link between cognitive impairment and risk of future stroke, but results have been inconsistent. We conducted a systematic review and meta-analysis of cohort studies to determine the association between cognitive impairment and risk of future stroke. We searched MED...
Gespeichert in:
| Veröffentlicht in: | Canadian Medical Association journal (CMAJ) 2014-10, Vol.186 (14), p.E536-E546 |
|---|---|
| Hauptverfasser: | , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | E546 |
|---|---|
| container_issue | 14 |
| container_start_page | E536 |
| container_title | Canadian Medical Association journal (CMAJ) |
| container_volume | 186 |
| creator | Lee, Meng Saver, Jeffrey L Hong, Keun-Sik Wu, Yi-Ling Liu, Hsing-Cheng Rao, Neal M Ovbiagele, Bruce |
| description | Several studies have assessed the link between cognitive impairment and risk of future stroke, but results have been inconsistent. We conducted a systematic review and meta-analysis of cohort studies to determine the association between cognitive impairment and risk of future stroke.
We searched MEDLINE and Embase (1966 to November 2013) and conducted a manual search of bibliographies of relevant retrieved articles and reviews. We included cohort studies that reported multivariable adjusted relative risks and 95% confidence intervals or standard errors for stroke with respect to baseline cognitive impairment.
We identified 18 cohort studies (total 121 879 participants) and 7799 stroke events. Pooled analysis of results from all studies showed that stroke risk increased among patients with cognitive impairment at baseline (relative risk [RR] 1.39, 95% confidence interval [CI] 1.24-1.56). The results were similar when we restricted the analysis to studies that used a widely adopted definition of cognitive impairment (i.e., Mini-Mental State Examination score < 25 or nearest equivalent) (RR 1.64, 95% CI 1.46-1.84). Cognitive impairment at baseline was also associated with an increased risk of fatal stroke (RR 1.68, 95% CI 1.21-2.33) and ischemic stroke (RR 1.65, 95% CI 1.41-1.93).
Baseline cognitive impairment was associated with a significantly higher risk of future stroke, especially ischemic and fatal stroke. |
| doi_str_mv | 10.1503/cmaj.140147 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4188684</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A384544169</galeid><sourcerecordid>A384544169</sourcerecordid><originalsourceid>FETCH-LOGICAL-c640t-1d4368c2083b7b92d8f6b409d03af5e60fa1807f76b84d0e14697ba0fbcf71363</originalsourceid><addsrcrecordid>eNqV0k-P1CAYBvDGaNzZ1ZN302hiNKYjFEqpB5PNxD-bbDRR90wofekw25ZZoLPOt5dx1s3UzEU4kMCPBwhvkjzDaI4LRN6pXq7mmCJMywfJDFPOs5zk1cNkhniOMlJRdpKcer9CsZG8fJyc5AUuSsToLLla2HYwwWwgNf1aGtfDEFI5NKkz_jq1OtVjGB2kPjh7De9TmfqtD9DLYFTqYGPg9g_vIchMDrLbeuOfJI-07Dw8vRvPkqtPH38uvmSX3z5fLM4vM8UoChluKGFc5YiTuqyrvOGa1RRVDSJSF8CQlpijUpes5rRBgCmryloiXStdYsLIWfJhn7se6x4aFe_uZCfWzvTSbYWVRkxXBrMUrd0IijlnnMaA13cBzt6M4IPojVfQdXIAO3qBGaoIKknOI335D13Z0cUH7xQmOCbiA9XKDoQZtI3nql2oOCecFpRiVkWVHVEtDBAvaQfQJk5P_IsjXq3NjThE8yMo9gZ6o46mvplsiCbAr9DK0Xtx8eP7f9ivU_vqwC5BdmHpbTcGYwc_hW_3UDnrvQN9_3MYiV1ti11ti31tR_388LPv7d9iJr8BJbjvuA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1613118818</pqid></control><display><type>article</type><title>Cognitive impairment and risk of future stroke: a systematic review and meta-analysis</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Journals@Ovid Complete</source><source>PubMed (Medline)</source><source>Alma/SFX Local Collection</source><creator>Lee, Meng ; Saver, Jeffrey L ; Hong, Keun-Sik ; Wu, Yi-Ling ; Liu, Hsing-Cheng ; Rao, Neal M ; Ovbiagele, Bruce</creator><creatorcontrib>Lee, Meng ; Saver, Jeffrey L ; Hong, Keun-Sik ; Wu, Yi-Ling ; Liu, Hsing-Cheng ; Rao, Neal M ; Ovbiagele, Bruce</creatorcontrib><description>Several studies have assessed the link between cognitive impairment and risk of future stroke, but results have been inconsistent. We conducted a systematic review and meta-analysis of cohort studies to determine the association between cognitive impairment and risk of future stroke.
We searched MEDLINE and Embase (1966 to November 2013) and conducted a manual search of bibliographies of relevant retrieved articles and reviews. We included cohort studies that reported multivariable adjusted relative risks and 95% confidence intervals or standard errors for stroke with respect to baseline cognitive impairment.
We identified 18 cohort studies (total 121 879 participants) and 7799 stroke events. Pooled analysis of results from all studies showed that stroke risk increased among patients with cognitive impairment at baseline (relative risk [RR] 1.39, 95% confidence interval [CI] 1.24-1.56). The results were similar when we restricted the analysis to studies that used a widely adopted definition of cognitive impairment (i.e., Mini-Mental State Examination score < 25 or nearest equivalent) (RR 1.64, 95% CI 1.46-1.84). Cognitive impairment at baseline was also associated with an increased risk of fatal stroke (RR 1.68, 95% CI 1.21-2.33) and ischemic stroke (RR 1.65, 95% CI 1.41-1.93).
Baseline cognitive impairment was associated with a significantly higher risk of future stroke, especially ischemic and fatal stroke.</description><identifier>ISSN: 0820-3946</identifier><identifier>EISSN: 1488-2329</identifier><identifier>DOI: 10.1503/cmaj.140147</identifier><identifier>PMID: 25157064</identifier><identifier>CODEN: CMAJAX</identifier><language>eng</language><publisher>Canada: Joule Inc</publisher><subject>Clinical trials ; Cognition disorders ; Cognitive Dysfunction - complications ; Dementia ; Diagnosis ; Humans ; Management ; Prevention ; Risk ; Risk Factors ; Stroke ; Stroke (Disease) ; Stroke - etiology ; Studies ; Systematic review</subject><ispartof>Canadian Medical Association journal (CMAJ), 2014-10, Vol.186 (14), p.E536-E546</ispartof><rights>2014 Canadian Medical Association or its licensors.</rights><rights>COPYRIGHT 2014 Joule Inc.</rights><rights>Copyright Canadian Medical Association Oct 7, 2014</rights><rights>1995-2014, Canadian Medical Association 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c640t-1d4368c2083b7b92d8f6b409d03af5e60fa1807f76b84d0e14697ba0fbcf71363</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4188684/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4188684/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25157064$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Meng</creatorcontrib><creatorcontrib>Saver, Jeffrey L</creatorcontrib><creatorcontrib>Hong, Keun-Sik</creatorcontrib><creatorcontrib>Wu, Yi-Ling</creatorcontrib><creatorcontrib>Liu, Hsing-Cheng</creatorcontrib><creatorcontrib>Rao, Neal M</creatorcontrib><creatorcontrib>Ovbiagele, Bruce</creatorcontrib><title>Cognitive impairment and risk of future stroke: a systematic review and meta-analysis</title><title>Canadian Medical Association journal (CMAJ)</title><addtitle>CMAJ</addtitle><description>Several studies have assessed the link between cognitive impairment and risk of future stroke, but results have been inconsistent. We conducted a systematic review and meta-analysis of cohort studies to determine the association between cognitive impairment and risk of future stroke.
We searched MEDLINE and Embase (1966 to November 2013) and conducted a manual search of bibliographies of relevant retrieved articles and reviews. We included cohort studies that reported multivariable adjusted relative risks and 95% confidence intervals or standard errors for stroke with respect to baseline cognitive impairment.
We identified 18 cohort studies (total 121 879 participants) and 7799 stroke events. Pooled analysis of results from all studies showed that stroke risk increased among patients with cognitive impairment at baseline (relative risk [RR] 1.39, 95% confidence interval [CI] 1.24-1.56). The results were similar when we restricted the analysis to studies that used a widely adopted definition of cognitive impairment (i.e., Mini-Mental State Examination score < 25 or nearest equivalent) (RR 1.64, 95% CI 1.46-1.84). Cognitive impairment at baseline was also associated with an increased risk of fatal stroke (RR 1.68, 95% CI 1.21-2.33) and ischemic stroke (RR 1.65, 95% CI 1.41-1.93).
Baseline cognitive impairment was associated with a significantly higher risk of future stroke, especially ischemic and fatal stroke.</description><subject>Clinical trials</subject><subject>Cognition disorders</subject><subject>Cognitive Dysfunction - complications</subject><subject>Dementia</subject><subject>Diagnosis</subject><subject>Humans</subject><subject>Management</subject><subject>Prevention</subject><subject>Risk</subject><subject>Risk Factors</subject><subject>Stroke</subject><subject>Stroke (Disease)</subject><subject>Stroke - etiology</subject><subject>Studies</subject><subject>Systematic review</subject><issn>0820-3946</issn><issn>1488-2329</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqV0k-P1CAYBvDGaNzZ1ZN302hiNKYjFEqpB5PNxD-bbDRR90wofekw25ZZoLPOt5dx1s3UzEU4kMCPBwhvkjzDaI4LRN6pXq7mmCJMywfJDFPOs5zk1cNkhniOMlJRdpKcer9CsZG8fJyc5AUuSsToLLla2HYwwWwgNf1aGtfDEFI5NKkz_jq1OtVjGB2kPjh7De9TmfqtD9DLYFTqYGPg9g_vIchMDrLbeuOfJI-07Dw8vRvPkqtPH38uvmSX3z5fLM4vM8UoChluKGFc5YiTuqyrvOGa1RRVDSJSF8CQlpijUpes5rRBgCmryloiXStdYsLIWfJhn7se6x4aFe_uZCfWzvTSbYWVRkxXBrMUrd0IijlnnMaA13cBzt6M4IPojVfQdXIAO3qBGaoIKknOI335D13Z0cUH7xQmOCbiA9XKDoQZtI3nql2oOCecFpRiVkWVHVEtDBAvaQfQJk5P_IsjXq3NjThE8yMo9gZ6o46mvplsiCbAr9DK0Xtx8eP7f9ivU_vqwC5BdmHpbTcGYwc_hW_3UDnrvQN9_3MYiV1ti11ti31tR_388LPv7d9iJr8BJbjvuA</recordid><startdate>20141007</startdate><enddate>20141007</enddate><creator>Lee, Meng</creator><creator>Saver, Jeffrey L</creator><creator>Hong, Keun-Sik</creator><creator>Wu, Yi-Ling</creator><creator>Liu, Hsing-Cheng</creator><creator>Rao, Neal M</creator><creator>Ovbiagele, Bruce</creator><general>Joule Inc</general><general>CMA Impact, Inc</general><general>Canadian Medical Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ISN</scope><scope>ISR</scope><scope>3V.</scope><scope>4T-</scope><scope>4U-</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8FQ</scope><scope>8FV</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2P</scope><scope>M3G</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20141007</creationdate><title>Cognitive impairment and risk of future stroke: a systematic review and meta-analysis</title><author>Lee, Meng ; Saver, Jeffrey L ; Hong, Keun-Sik ; Wu, Yi-Ling ; Liu, Hsing-Cheng ; Rao, Neal M ; Ovbiagele, Bruce</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c640t-1d4368c2083b7b92d8f6b409d03af5e60fa1807f76b84d0e14697ba0fbcf71363</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Clinical trials</topic><topic>Cognition disorders</topic><topic>Cognitive Dysfunction - complications</topic><topic>Dementia</topic><topic>Diagnosis</topic><topic>Humans</topic><topic>Management</topic><topic>Prevention</topic><topic>Risk</topic><topic>Risk Factors</topic><topic>Stroke</topic><topic>Stroke (Disease)</topic><topic>Stroke - etiology</topic><topic>Studies</topic><topic>Systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Meng</creatorcontrib><creatorcontrib>Saver, Jeffrey L</creatorcontrib><creatorcontrib>Hong, Keun-Sik</creatorcontrib><creatorcontrib>Wu, Yi-Ling</creatorcontrib><creatorcontrib>Liu, Hsing-Cheng</creatorcontrib><creatorcontrib>Rao, Neal M</creatorcontrib><creatorcontrib>Ovbiagele, Bruce</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Canada</collection><collection>Science in Context</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>University Readers</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>ProQuest - Health & Medical Complete保健、医学与药学数据库</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Canadian Business & Current Affairs Database</collection><collection>Canadian Business & Current Affairs Database (Alumni Edition)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>PML(ProQuest Medical Library)</collection><collection>Psychology Database</collection><collection>ProQuest Research Library</collection><collection>ProQuest Science Journals</collection><collection>CBCA Reference & Current Events</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Canadian Medical Association journal (CMAJ)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Meng</au><au>Saver, Jeffrey L</au><au>Hong, Keun-Sik</au><au>Wu, Yi-Ling</au><au>Liu, Hsing-Cheng</au><au>Rao, Neal M</au><au>Ovbiagele, Bruce</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cognitive impairment and risk of future stroke: a systematic review and meta-analysis</atitle><jtitle>Canadian Medical Association journal (CMAJ)</jtitle><addtitle>CMAJ</addtitle><date>2014-10-07</date><risdate>2014</risdate><volume>186</volume><issue>14</issue><spage>E536</spage><epage>E546</epage><pages>E536-E546</pages><issn>0820-3946</issn><eissn>1488-2329</eissn><coden>CMAJAX</coden><abstract>Several studies have assessed the link between cognitive impairment and risk of future stroke, but results have been inconsistent. We conducted a systematic review and meta-analysis of cohort studies to determine the association between cognitive impairment and risk of future stroke.
We searched MEDLINE and Embase (1966 to November 2013) and conducted a manual search of bibliographies of relevant retrieved articles and reviews. We included cohort studies that reported multivariable adjusted relative risks and 95% confidence intervals or standard errors for stroke with respect to baseline cognitive impairment.
We identified 18 cohort studies (total 121 879 participants) and 7799 stroke events. Pooled analysis of results from all studies showed that stroke risk increased among patients with cognitive impairment at baseline (relative risk [RR] 1.39, 95% confidence interval [CI] 1.24-1.56). The results were similar when we restricted the analysis to studies that used a widely adopted definition of cognitive impairment (i.e., Mini-Mental State Examination score < 25 or nearest equivalent) (RR 1.64, 95% CI 1.46-1.84). Cognitive impairment at baseline was also associated with an increased risk of fatal stroke (RR 1.68, 95% CI 1.21-2.33) and ischemic stroke (RR 1.65, 95% CI 1.41-1.93).
Baseline cognitive impairment was associated with a significantly higher risk of future stroke, especially ischemic and fatal stroke.</abstract><cop>Canada</cop><pub>Joule Inc</pub><pmid>25157064</pmid><doi>10.1503/cmaj.140147</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0820-3946 |
| ispartof | Canadian Medical Association journal (CMAJ), 2014-10, Vol.186 (14), p.E536-E546 |
| issn | 0820-3946 1488-2329 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4188684 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Journals@Ovid Complete; PubMed (Medline); Alma/SFX Local Collection |
| subjects | Clinical trials Cognition disorders Cognitive Dysfunction - complications Dementia Diagnosis Humans Management Prevention Risk Risk Factors Stroke Stroke (Disease) Stroke - etiology Studies Systematic review |
| title | Cognitive impairment and risk of future stroke: a systematic review and meta-analysis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T07%3A01%3A55IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Cognitive%20impairment%20and%20risk%20of%20future%20stroke:%20a%20systematic%20review%20and%20meta-analysis&rft.jtitle=Canadian%20Medical%20Association%20journal%20(CMAJ)&rft.au=Lee,%20Meng&rft.date=2014-10-07&rft.volume=186&rft.issue=14&rft.spage=E536&rft.epage=E546&rft.pages=E536-E546&rft.issn=0820-3946&rft.eissn=1488-2329&rft.coden=CMAJAX&rft_id=info:doi/10.1503/cmaj.140147&rft_dat=%3Cgale_pubme%3EA384544169%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1613118818&rft_id=info:pmid/25157064&rft_galeid=A384544169&rfr_iscdi=true |