New Study Suggests 60% Of Stroke Survivors Could Develop Cognitive Decline Within One Year

According to a new study and statement from the American Stroke Association, up to 60% of all stroke survivors develop cognitive issues within one year, and one-third develop dementia within five years.

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The American Stroke Association released a new scientific statement that revealed up to 60% of stroke survivors develop memory and thinking problems within a year, while one-third develop dementia within five years. 

“The numbers are staggering, right? This is a call to action to up our game and focus on prevention,” said Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver.

According to 2023 statistics from the American Heart Association, about 3.6% of the US adult population, around 9.4 million American adults, report having a stroke. 

“Cognitive impairment is an often under-reported and under-diagnosed but yet very common condition stroke survivors frequently deal with,” said Dr. Nada El Husseini, an associate professor of neurology at Duke University Medical Center in Durham, North Carolina, in a statement.

“About 40% of the survivors of stroke have mild cognitive impairment that does not meet the diagnostic criteria for dementia. Mild or not, the mental difficulties can seriously affect quality of life,” said El Husseini.

“Cognitive impairment after stroke ranges from mild impairment to dementia and may affect many aspects of life, such as remembering, thinking, planning, language and attention, as well as a person’s ability to work, drive or live independently.”

Cognitive impairment is most common within the first two weeks after a stroke, the statement continued. The American Stroke Association’s statement also states that around 20% of people who experience minor cognitive impairment after a stroke fully recover their cognitive function within the first six months following the stroke. 

The statement also wrote that Ischemic strokes, which are strokes caused by a clot in the blood vessels that feed into the brain, account for 87% of all strokes. Hemorrhagic strokes, brain bleeds caused by a rupture of a weak vessel in the brain, account for 13% of all strokes. 

According to the National Institute of Neurological Disorders and Stroke, signs of a stroke include “sudden numbness or weakness in the face, arm or leg, especially on one side of the body. Sudden confusion, trouble speaking or difficulty understanding speech. Sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, loss of balance or lack of coordination, and sudden severe headache with no known cause.” 

Experts say any symptom, even those that only last a few moments and disappear, should be taken seriously, as it could signal a more serious stroke to come.  

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“It’s never too late for prevention, but serious effort is needed after even mild stroke to extinguish the fire if you will, with aggressive change and aggressive medication therapy when appropriate. It should push people to make very drastic lifestyle changes: Eat better, exercise more, go on the appropriate statins or aspirins or whatever their doctor suggests are appropriate so that their risk is as low as possible.” 

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Permanent brain damage can occur within minutes to hours of a stroke due to a lack of oxygen reaching cells, causing them to die; other brain cells can die due to bleeding in the brain. 

The US Centers for Disease Control and Prevention recommend memorizing the acronym F.A.S.T. to help quickly identify the signs of stroke to ideally lessen the impact of the stroke as well. 

F – Face: ask the person to smile and observe if one side of their face droops. 

A – Arms: Ask this individual to raise both arms and observe if one seems to drift downward. 

S – Speech: Tell the person to repeat a simple phrase and see if their speech seems slurred or slow. 

T – Time: When any of these signs appear, call 911 immediately. 

The CDC also advises to record the time where any symptoms begin appearing to help medical professionals find the best course of treatment. El Husseini stated that when one experiences a stroke, they should be diligent when it comes to getting evaluations regarding their cognitive function. 

“Stroke survivors should be systematically evaluated for cognitive impairment so that treatment may begin as soon as possible after signs appear,” El Husseini said.

“Perhaps the most pressing need, however, is the development of effective and culturally relevant treatments for post-stroke cognitive impairment. We hope to see big enough clinical trials that assess various techniques, medications and lifestyle changes in diverse groups of patients that may help improve cognitive function,” she concluded.