Jump to content
  •  

ksmith

Memory and thinking ability keep getting worse for years after a stroke, (2015)

Recommended Posts

July 07, 2015

ANN ARBOR, Mich. -- A stroke happens in an instant. And many who survive one report that their brain never works like it once did. But new research shows that these problems with memory and thinking ability keep getting worse for years afterward – and happen faster than normal brain aging. 

After a stroke, memory and thinking ability continue to decline - faster than for non-stroke survivors.

Stroke survivors also had a faster rate of developing cognitive impairment over the years after stroke compared to their pre-stroke rate. The study results are published in the Journal of the American Medical Association this week. 

Lead author Deborah A. Levine, M.D., M.P.H., of the University of Michigan Medical School and VA Ann Arbor Healthcare System and her U-M colleagues used data from 23,572 Americans aged 45 years or older from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study led by the University of Alabama at Birmingham and funded by the National Institutes of Health. 

“We found that stroke is associated with cognitive decline over the long-term,” says Levine. “That is, survivors had accelerated and persistent declines in memory and thinking ability during the years after stroke -- even after accounting for their cognitive changes before and early after the event.”  

Participants had no history of cognitive impairment when they entered the large population-based study in the mid-2000s. They had tests of their memory and thinking ability at the beginning of the study and at regular intervals during follow-up. They were monitored twice per year for acute stroke events; suspected strokes were confirmed by study physicians using medical records.

Over the next six to 10 years, 515 of them had a stroke, and researchers compared their test results with those from the 23,057 who remained stroke-free. 

Because they had information on how stroke survivors’ memory and thinking ability changed over time before the stroke, Levine and her colleagues could separate the declines in brain function associated with aging from declines in brain function associated with stroke. 

In their study, stroke was associated with declines in global cognition, new learning, and verbal memory early after stroke as well as accelerated and persistent declines in global cognition and thinking ability over the years after the event.

  

“Stroke is common, costly, and disabling, and cognitive decline is a major cause of disability in stroke survivors,” says Levine, who holds faculty appointments in internal medicine and neurology at U-M. “Yet cognitive decline after stroke has not received enough attention. We hope these findings will shine a spotlight on stroke survivors’ long-term cognitive needs.”

The findings suggest a need for better long-term follow-up care for the nation’s 7 million stroke survivors, including therapy to retain or even regain cognitive ability. 

“Our results suggest that stroke survivors warrant monitoring for mounting cognitive impairment over the years after the event,” says Levine. “Health systems and payers will need to develop cost-effective systems of care that will best manage the long-term needs and cognitive problems of this growing and vulnerable stroke survivor population.

Levine and her colleagues also suggest that their results mean long-term cognitive ability could be a new marker for measuring the effects of therapies to treat the initial effects of stroke.

Levine and her colleagues note that research is needed to determine whether the acute and also accelerated long-term cognitive declines after stroke are the result of incomplete rehabilitation from the initial stroke, subsequent brain injury due to uncontrolled risk factors, behavioral changes, or other mechanisms.  

The research was funded by the National Institute for Neurological Disorders and Stroke and by the National Institute on Aging (NS041588 and AG040278). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the U.S. Department of Veterans Affairs.

In addition to Levine, the study’s authors are U-M’s Andrzej T. Galecki, M.D., Ph.D., Kenneth M. Langa, M.D., Ph.D., Mohammed U. Kabeto, M.S., and Bruno Giordani, Ph.D.; Indiana University’s Frederick W. Unverzagt, Ph.D.; and UAB School of Medicine’s Virginia G. Wadley, Ph.D. 

Levine, Langa and Kabeto are members of the Division of General Medicine; Langa also holds a position in the U-M Institute for Social Research and Galecki and Langa both have a dual faculty appointment in the U-M School of Public Health. Giordani is a neuropsychologist in the U-M Department of Psychiatry.

Levine is a member of the U-M Comprehensive Stroke Program, which includes treatment for stroke from emergency care to long-term follow-up and is certified as a Comprehensive Stroke Center. Langa and Levine are members of the U-M Institute for Healthcare Policy and Innovation (link is external). Levine, Langa and Kabeto are members of the VA Center for Clinical Management Research (link is external)

Patients interested in learning more about stroke care at the U-M Health System should call 1-888-287-1082 or visit www.uofmehealth.org/stroke (link is external).  

Reference: JAMA 2015; 314(1):41-51. doi=10.1001/jama.2015.6968 (link is externa    Deborah Levine, M.D., MPH

                                                                                                           Deborah Levine, M.D., MPH

Share this post


Link to post
Share on other sites

Kinda scary, I notice the brain supplement I was on helped with my clarity. I have been off it for three days and miss it. Just reordered a 30day supply.

Share this post


Link to post
Share on other sites

I've noticed my short-term memory stinks, and yes, it has gotten worse over the years.  Stuff like not being able to remember what I ate the day prior; I also leave notes all over the house, and I use the timer on the stove too!  (Sometimes even a note reading why I have set the timer.:rolleyes:)  

Share this post


Link to post
Share on other sites

i have been doing meditation and taking lions mane mushroom supplement.     my memory is better and       i feel more clear mentally

there is a book about lions mane mushrooms.

Share this post


Link to post
Share on other sites

I'm glad you found a way to help. I too go to mediation group and I feel that also helps .. 

Share this post


Link to post
Share on other sites

This was a really interesting article. I've noticed so much lately where I forget my point mid sentence and have been forgetting my meds and forgetting to take my phone with me. Several things. I've been dealing with depression and anxiety which makes it so worse. Hopefully in the future they will have better ways to address this issue and ways to help improve someone's difficulties.

Share this post


Link to post
Share on other sites

I'm with you Tracy.  Things improved for a while, not starting to slip.  And the depression and anxiety creep in and make it worse.

Share this post


Link to post
Share on other sites

I have noticed that my memory is getting worse, but i truly believe that if i worry to much I get worse. my husband and i will joke about my forgetfulness. I use a calandar to note down my doctors visit, and use one for my center to remind me when there is a field trip or the center is closed. i had started doing word search, and so enjoy playing board games with my grand kids.I do a shopping list notes, but sometimes forget the list. lol Oh well it could be worse :hug:

Yvonne

Share this post


Link to post
Share on other sites

:smile:Me too Yvonne. I have a planner where I write everything. I try to look at it at least once a day to remind me what's coming up. My mom and I find humor in our forgetfulness (mom and I are on the same wavelength right now). Never a moment of judgement...honesty after a few minutes I forget that I forgot lol. I just try my best by trying to be consistent with my planner and all the forgetfulness otherwise I just don't let it get me down (for the most part...there have been seriously scary moments of losing my keys in a multitude of places).:yikes:

Share this post


Link to post
Share on other sites

It's all about establishing patterns and being consistent, It's when I can't use my systems that I get in a real mess, e.g. at home my glasses get left on the kitchen bench by the toaster each night before I go to bed, but when I stay at the family country house my bedroom is upstairs so the glasses come to my room, and then the next morning I spend an anxious 10 minutes trying to work out where I've put them.

Share this post


Link to post
Share on other sites

Heather exactly! My really uh oh moments are when I leave my keys not in my purse...it's my go to habit. Like if left in another room, at a store, in my trunk once, in my pants back pocket lol. I took a whole hour one day frantic for my keys and found them in my coat pocket.:insane:

Share this post


Link to post
Share on other sites

My classic was when after a half hour of frantic searching for my spectacles, my wife said, rather sarcastically, "Why don't you settle for the ones you are wearing?"

Deigh:biggrin:

Share this post


Link to post
Share on other sites

:lol: quite right

Share this post


Link to post
Share on other sites

I got ready one morning to go to an important doc appt and waited for the van to fetch me only to discover that I had forgotten to schedule the spur of the moment need for transportation. I checked my planner and realised I thought I had done it on the friday that I was told they gave me an extra long acting pain med rather than an immediate release. After lunch I ran off to bingo and got sleepy dizzy and thought I just needed to nap. I woke up around midnight. So on Monday morning I was convinced that I had scheduled the van after the doc appt as usual and never worried about it.

 

My system is to keep the confirmation numbers on my planner calendar and double chech them. But a pop up one and a false memory meant I got ready for nothing. Yes I have a new appt now. Embarassed I said oh! transportation trouble.

These drugs can do a number on my memory.

 

Share this post


Link to post
Share on other sites

They only discovered the medication error later and told me Tuesday as law requires them to inform patient.  This is second time they messed up my Oxy. They are both tiny pink but one is darker. If I do not look close I fail to catch a mistake.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

×