StrokeCog study: modelling and modifying stroke-related cognitive impairment through innovative application of health psychology principles

Abstract

Rationale: Cognitive impairment is a very common stroke outcome. Evidence indicates a strong association between post-stroke cognitive impairment and subsequent development of dementia, often associated with poor medication adherence and further stroke. Despite its prevalence, post-stroke cognitive impairment is arguably the “lost dimension†of stroke rehabilitation, with rehabilitation of cognitive impairment receiving substantially less attention than rehabilitation of physical function. Aims: The aim of this symposium is to (i) profile post-stroke cognitive impairment; (ii) describe the long-term impact of cognitive impairment and medication adherence for stroke-related morbidity and mortality; (iii) profile the development of an innovative epidemiological modeling platform that profiles the cognitive impairment – dementia continuum and enables evaluation of the effects of interventions to rehabilitate cognitive impairment post-stroke; (iv) develop and test a post-stroke cognitive intervention in a pilot RCT using health psychology principles of behaviour change; and (v) cost post-stroke cognitive impairment and the continuum to dementia, and conduct an evaluation of cost-effectiveness of hypothetical interventions to reduce post-stroke cognitive impairment. Summary: This symposium presents five papers focussed on epidemiological and economic modelling of post-stroke cognitive impairment and the potential epidemiological and cost implications of delivering post-stroke cognitive rehabilitation as part of routine care. As part of the StrokeCog study, a rehabilitation intervention is being developed using health behaviour change theory, and pilot RCT findings will be tested for effectiveness in epidemiological and economic models. The symposium will present 5 papers, followed by a discussant. The five papers will detail the context and study components of the StrokeCog study, with a discussion by Professor Marie Johnston to conclude the symposium. Based on innovative application of principles of health psychology, this research programme will yield a number of deliverables that make an original contribution to national and international research and literature.