Extrait

Background and study aims Previous research indicates that many patients who have suffered from a stroke or mini-stroke (Transient Ischemic Attack [TIA]) are already showing signs of cognitive decline (problems with thinking, reasoning and remembering) at the time of diagnosis. Previous research also indicates that about a third of stroke patients who have normal cognition at diagnosis go on to develop dementia as early as 3 months after stroke. The aim of this study is to find out if the early detection of cognitive decline at the time of stroke or mini-stroke (TIA) diagnosis can prevent, slow down or even reverse the onset of dementia. The study hopes to find out if improved monitoring and control of vascular risk factors such as high blood pressure, high cholesterol, irregular heart beat (atrial fibrillation) and diabetes, can slow down cognitive decline. Who can participate? Adult patients with mild ischemic stroke or TIA What does the study involve? At the time of stroke/TIA diagnosis a simple cognitive screening test is carried out. The score the patient gets determines what part of the study they can participate in. Patients with a score of less than 20 are not able to take part in the study. Patients with a score of 26 or over are invited to participate in the observational study. Patients with a score of 20-25 are invited to participate in the feasibility study. The goal of the observational study is to see if there is a link between vascular risk factors, control of these risk factors and cognitive function after stroke/TIA. Participants in the observational study have their vascular risk factors (e.g. high blood pressure, high cholesterol, irregular heart beat [atrial fibrillation]) and diabetes assessed at the start of the study and after 1 year. The goal of the feasibility study is to evaluate the feasibility of conducting a hospital-based study of stroke/TIA patients who are at risk of further cognitive decline. Participants are randomly allocated to one of two groups: an intervention group and a control group. Participants in the intervention group have targets set for each of their risk factors which are monitored by the hospital and by their GP. Participants in the control group receive standard care. The cognitive test is repeated after 6 months and 1 year. What are the possible risks and benefits of taking part in this study? Participants with a score of 26 or over will be reassured that they have normal cognition. Participants with a score of 20-25 who are allocated to the feasibility intervention group will have the benefit of closer and frequent monitoring of risk factors which may possibly reduce risk of a further stroke/TIA. They might also have the advantage of reducing further cognitive decline. Participants with a score of less than 20 will be referred to their GP and to appropriate services if required. Participants scoring less than 26 may experience some anxiety. Referral and support will be given. By doing so, we hope that the anxiety will be reduced. Where is the study run from? Norfolk and Norwich University Hospital (NNUH) (UK) When is the study starting and how long is it expected to run for? August 2015 to April 2017 Who is funding the study? National Institute for Health Research (UK) Who are the main contacts? 1. Prof. John Potter 2. Prof. Phyo Myint

Critère d'inclusion

• Topic: Stroke; Subtopic: Prevention; Disease: Therapy type

Liens

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