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The StrokeCog study: modelling and modifying the consequences of stroke-related cognitive impairment through intervention

Background: Stroke is the second most common cause of death worldwide and a significant contributor to adult disability. While rehabilitation of physical function in stroke is widely researched, rehabilitation of cognitive impairment receives significantly less attention and is arguably the “lost dimension” of stroke rehabilitation.
Aims and objectives: The aim of this study is to profile cognitive function in acute and long-term stroke patients and to test the impact of a brief intervention. The objectives are to (i) build an innovative epidemiological modeling platform that enables evaluation of the effects of interventions to rehabilitate cognitive impairment post-stroke; (ii) develop and test a post-stroke cognitive intervention in a pilot RCT; and (iii) cost post-stroke cognitive impairment and the continuum to dementia, and conduct an evaluation of potential cost-effectiveness of hypothetical interventions to reduce post-stroke cognitive impairment.
Results and conclusions: This study will yield a number of deliverables that make an original contribution to national and international research and literature. These include a systematic review of interventions for patients after stroke with cognition as a primary outcome; creation of an epidemiological meta-dataset and an epidemiological modelling platform profiling post-stroke cognitive impairment and the continuum to dementia and death; an intervention that has been tested in a pilot RCT; a protocol for testing the intervention in definitive RCT if found to be effective in the pilot study; an economic model of the post-stroke cognitive impairment-dementia continuum, with a particular focus on the need for long-term care as a result; and a cost-effectiveness analysis of hypothetical interventions to improve/prevent further decline in cognitive function. Findings from this research programme will provide, for the first time in Ireland, critical data enabling service planners and providers to plan services addressing cognitive impairment post-stroke both in hospital and community settings.