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中风后的二级预防与认知功能:ASPIRE-S队列5年随访研究方案

Secondary prevention and cognitive function after stroke: a study protocol for a 5-year follow-up of the ASPIRE-S cohort.

作者信息

Rohde Daniela, Williams David, Gaynor Eva, Bennett Kathleen, Dolan Eamon, Callaly Elizabeth, Large Margaret, Hickey Anne

机构信息

Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.

Department of Geriatric and Stroke Medicine, Royal College of Surgeons in Ireland and Beaumont Hospital, Dublin, Ireland.

出版信息

BMJ Open. 2017 Mar 27;7(3):e014819. doi: 10.1136/bmjopen-2016-014819.

Abstract

INTRODUCTION

Cognitive impairment is common following stroke and can increase disability and levels of dependency of patients, potentially leading to greater burden on carers and the healthcare system. Effective cardiovascular risk factor control through secondary preventive medications may reduce the risk of cognitive decline. However, adherence to medications is often poor and can be adversely affected by cognitive deficits. Suboptimal medication adherence negatively impacts secondary prevention targets, increasing the risk of recurrent stroke and further cognitive decline. The aim of this study is to profile cognitive function and secondary prevention, including adherence to secondary preventive medications and healthcare usage, 5 years post-stroke. The prospective associations between cognition, cardiovascular risk factors, adherence to secondary preventive medications, and rates of recurrent stroke or other cardiovascular events will also be explored.

METHODS AND ANALYSIS

This is a 5-year follow-up of a prospective study of the Action on Secondary Prevention Interventions and Rehabilitation in Stroke (ASPIRE-S) cohort of patients with stroke. This cohort will have a detailed assessment of cognitive function, adherence to secondary preventive medications and cardiovascular risk factor control.

ETHICS AND DISSEMINATION

Ethical approval for this study was granted by the Research Ethics Committees at Beaumont Hospital, Dublin and Connolly Hospital, Dublin, Mater Misericordiae University Hospital, Dublin, and the Royal College of Surgeons in Ireland. Findings will be disseminated through presentations and peer-reviewed publications.

摘要

引言

认知障碍在中风后很常见,会增加患者的残疾程度和依赖水平,可能给照顾者和医疗系统带来更大负担。通过二级预防药物有效控制心血管危险因素可能会降低认知衰退的风险。然而,药物依从性往往较差,并且会受到认知缺陷的不利影响。药物依从性欠佳会对二级预防目标产生负面影响,增加复发性中风和进一步认知衰退的风险。本研究的目的是描绘中风后5年的认知功能和二级预防情况,包括二级预防药物的依从性和医疗保健使用情况。还将探讨认知、心血管危险因素、二级预防药物依从性与复发性中风或其他心血管事件发生率之间的前瞻性关联。

方法与分析

这是对中风二级预防干预与康复行动(ASPIRE-S)中风患者队列进行的前瞻性研究的5年随访。该队列将对认知功能、二级预防药物依从性和心血管危险因素控制进行详细评估。

伦理与传播

本研究已获得都柏林博蒙特医院、都柏林康诺利医院、都柏林仁慈圣母大学医院以及爱尔兰皇家外科医学院的研究伦理委员会的伦理批准。研究结果将通过报告和同行评审出版物进行传播。

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