Wardlaw Joanna M, Doubal Fergus, Brown Rosalind, Backhouse Ellen, Woodhouse Lisa, Bath Philip, Quinn Terence J, Robinson Thompson, Markus Hugh S, McManus Richard, O'Brien John T, Werring David J, Sprigg Nikola, Parry-Jones Adrian, Touyz Rhian M, Williams Steven, Mah Yee-Haur, Emsley Hedley
Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK.
Eur Stroke J. 2021 Mar;6(1):89-101. doi: 10.1177/2396987320953312. Epub 2020 Oct 11.
Stroke commonly affects cognition and, by definition, much vascular dementia follows stroke. However, there are fundamental limitations in our understanding of vascular cognitive impairment, restricting understanding of prevalence, trajectories, mechanisms, prevention, treatment and patient-service needs.
Rates, Risks and Routes to Reduce Vascular Dementia (R4VaD) is an observational cohort study of post-stroke cognition. We aim to recruit a wide range of patients with stroke, presenting to geographically diverse UK hospitals, into a longitudinal study to determine rates of, and risk factors for, cognitive and related impairments after stroke, to assess potential mechanisms and improve prediction models.
We will recruit at least 2000 patients within six weeks of stroke with or without capacity to consent and collect baseline demographic, clinical, socioeconomic, lifestyle, cognitive, neuropsychiatric and informant data using streamlined patient-centred methods appropriate to the stage after stroke. We will obtain more detailed assessments at four to eight weeks after the baseline assessment and follow-up by phone and post yearly to at least two years. We will assess diagnostic neuroimaging in all and high-sensitivity inflammatory markers, genetics, blood pressure and diffusion tensor imaging in mechanistic sub-studies. R4VaD will provide reliable data on long-term cognitive function after stroke, stratified by prior cognition, stroke- and patient-related variables and improved risk prediction. It will create a platform enabling sharing of data, imaging and samples. Participants will be consented for re-contact, facilitating future clinical trials and providing a resource for the stroke and dementia research communities.
中风通常会影响认知，根据定义，许多血管性痴呆继发于中风之后。然而，我们对血管性认知障碍的理解存在根本性局限，这限制了我们对其患病率、病程、机制、预防、治疗及患者服务需求的认识。
降低血管性痴呆的发生率、风险及途径（R4VaD）研究是一项关于中风后认知的观察性队列研究。我们旨在招募来自英国各地不同医院、患有各种中风的患者，开展一项纵向研究，以确定中风后认知及相关障碍的发生率和危险因素，评估潜在机制并改进预测模型。
我们将在中风后六周内招募至少2000名患者，无论其是否有同意能力，并采用适合中风后阶段的简化的以患者为中心的方法，收集基线人口统计学、临床、社会经济、生活方式、认知、神经精神及知情者数据。我们将在基线评估后四至八周进行更详细的评估，并每年通过电话和邮寄方式随访至少两年。我们将对所有人进行诊断性神经影像学检查，并在机制性亚研究中评估高敏炎症标志物、遗传学、血压和扩散张量成像。R4VaD将提供中风后长期认知功能的可靠数据，按先前认知、中风及患者相关变量进行分层，并改进风险预测。它将创建一个平台，实现数据、影像和样本的共享。参与者将同意再次联系，以促进未来的临床试验，并为中风和痴呆研究群体提供资源。
