Multidomain intervention for the prevention of cognitive decline after stroke - a pooled patient-level data analysis

ASPIS Study Group, K Matz

Research output: Journal article (peer-reviewed)Journal article

12 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE: The aim of this pooled patient-level data analysis was to test if multidomain interventions, addressing several modifiable vascular risk factors simultaneously, are more effective than usual post-stroke care for the prevention of cognitive decline after stroke.

METHODS: This pooled patient-level data analysis included two randomized controlled trials using a multidomain approach to target vascular risk factors in stroke patients and cognition as primary outcome. Changes from baseline to 12 months in the trail making test (TMT)-A, TMT-B and 10-words test were analysed using stepwise backward linear mixed models with study as random factor. Two analyses were based on the intention-to-treat (ITT) principle using different imputation approaches and one was based on complete cases.

RESULTS: Data from 322 patients (157 assigned to multidomain intervention and 165 to standard care) were analysed. Differences between randomization groups for TMT-A scores were found in one ITT model (P = 0.014) and approached significance in the second ITT model (P = 0.087) and for complete cases (P = 0.091). No significant intervention effects were found for any of the other cognitive variables.

CONCLUSION: We found indications that multidomain interventions compared with standard care can improve the scores in TMT-A at 1 year after stroke but not those for TMT-B or the 10-words test. These results have to be interpreted with caution due to the small number of patients.

Original languageEnglish
Pages (from-to)1182-1188
Number of pages7
JournalEuropean Journal of Neurology
Volume25
Issue number9
DOIs
Publication statusPublished - Sep 2018

Keywords

  • Aged
  • Cognitive Dysfunction/etiology
  • Combined Modality Therapy
  • Female
  • Humans
  • Intention to Treat Analysis
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Risk Factors
  • Stroke/complications
  • Stroke Rehabilitation/methods
  • Trail Making Test
  • Treatment Outcome

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