scholarly journals Investigating on-road lane maintenance and speed regulation in post-stroke driving: a pilot case-control study

2019 ◽  
Author(s):  
Heng Zhou ◽  
Qian (Chayn) Sun ◽  
Alison Blane ◽  
Brett Hughes ◽  
Torbjörn Falkmer ◽  
...  
Keyword(s):  
Cognitive Abilities ◽  
Intervention Program ◽  
Speed Control ◽  
Executive Dysfunction ◽  
Case Control ◽  
Older Drivers ◽  
Post Stroke ◽  
Speed Regulation ◽  
Stroke Population ◽  
Lane Keeping

ABSTRACTThe post-stroke population is expected to rise and the cohort of post-stroke individuals who wish to return to driving is likely to rapidly increase too. Stroke can adversely affect coordination and judgement of drivers due to the executive dysfunction, which is relatively common in the post-stroke population but often undetected. Quantitatively examining vehicle control performance in post-stroke driving becomes essential to inspect whether and where post-stroke drivers are risky. To date, it is unclear as to which indicators, such as lane keeping or speed control, can differentiate driving performance of post-stroke drivers from that of normal (neurotypical) older drivers. By employing a case-control design using advanced vehicle movement tracking and analysis technology, this pilot study aimed to compare the variations in driving trajectory, lane keeping and speed control between the two groups using spatial and statistical techniques. The results showed that the mean Standard Deviation of Lane Deviation (SDLD) in post-stroke participants was higher than those of normal participants in complex driving tasks (U-turn and left turn) but almost the same in simple driving tasks (straight-line sections). No statistically significant differences were found in the speed maintenance between the post-stroke drivers and the normal adults. The findings indicate that, although older drivers can still drive as they need to after a stroke, the decline in cognitive abilities still imposes higher cognitive workload and more effort for post-stroke older drivers. Future studies can investigate post-stroke adults’ driving behaviour at more challenging driving scenarios, or design driving intervention program to improve their executive function in driving.

scholarly journals Investigating On-Road Lane Maintenance and Speed Regulation in Post-Stroke Driving: A Pilot Case–Control Study

Geriatrics ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 16
Author(s):  
Heng Zhou ◽  
Qian (Chayn) Sun ◽  
Alison Blane ◽  
Brett Hughes ◽  
Torbjörn Falkmer ◽  
...  
Keyword(s):  
Cognitive Abilities ◽  
Speed Control ◽  
Executive Dysfunction ◽  
Case Control ◽  
Older Drivers ◽  
Control Performance ◽  
Post Stroke ◽  
Speed Regulation ◽  
Stroke Population ◽  
Lane Keeping

Stroke can adversely affect the coordination and judgement of drivers due to executive dysfunction, which is relatively common in the post-stroke population but often undetected. Quantitatively examining vehicle control performance in post-stroke driving becomes essential to inspect whether and where post-stroke older drivers are risky. To date, it is unclear as to which indicators, such as lane keeping or speed control, can differentiate the driving performance of post-stroke older drivers from that of normal (neurotypical) older drivers. By employing a case–control design using advanced vehicle movement tracking and analysis technology, this pilot study aimed to compare the variations in driving trajectory, lane keeping and speed control between the two groups of older drivers using spatial and statistical techniques. The results showed that the mean standard deviation of lane deviation (SDLD) in post-stroke participants was higher than that of normal participants in complex driving tasks (U-turn and left turn) but almost the same in simple driving tasks (straight line sections). No statistically significant differences were found in the speed control performance. The findings indicate that, although older drivers can still drive as they need to after a stroke, the decline in cognitive abilities still imposes a higher cognitive workload and more effort for post-stroke older drivers. Future studies can investigate post-stroke adults’ driving behaviour at more challenging driving scenarios or design driving intervention programs to improve their executive function in driving.

scholarly journals Long-Term Outcomes in Stroke Patients with Cognitive Impairment: A Population-Based Study

Geriatrics ◽  
2020 ◽  
Vol 5 (2) ◽  
pp. 32 ◽  
Author(s):  
Majed Obaid ◽  
Clare Flach ◽  
Iain Marshall ◽  
Charles D. A. Wolfe ◽  
Abdel Douiri
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Cognitive Abilities ◽  
Population Based ◽  
Post Stroke ◽  
Relative Risks ◽  
Stroke Population ◽  
Increased Risk ◽  
One Year ◽  
State Examination

This study assesses five year outcomes of patients with cognitive deficits within the first three months after stroke. Population-based data from the South London Stroke Register between 1995 and 2018 were studied. Cognitive function was assessed using the Abbreviated-Mental-Test or Mini-Mental-State-Examination. Multivariable Poisson regression models with robust standard errors were constructed, to evaluate relative risks (RRs) and associations between post-stroke deterioration in cognitive function during the first three months on dependency, mortality, depression and institutionalisation. A total of 6504 patients with first-ever strokes were registered with a mean age of 73 (SD: 13.2). During the first three months post-stoke, approximately one-third of these stroke survivors either cognitively improved (37%), deteriorated (30%) or remained unchanged (33%). Post-stroke cognitive impairment was associated with increases, in five years, of the risks of mortality, dependency, depression and being institutionalised by RRs 30% (95% confidence interval: 1.1–1.5), 90% (1.3–2.6), 60% (1.1–2.4) and 50% (1.1–2.3), respectively. Deterioration in cognitive function by 10% or more between seven days and three months was associated with an approximate two-fold increased risk in mortality, dependency, and being institutionalised after one year, compared to stable cognitive function; RRs 80% (1.1–3.0), 70% (1.2–2.4) and two-fold (1.3–3.2), respectively. Monitoring further change to maintain cognitive abilities should be a focus to improve outcomes.

Improvement of somatopsychic and cognitive abilities in a post-stroke patient treated with neurotrophic factors

Psihiatru ro ◽  
2020 ◽  
Vol 4 (63) ◽  
pp. 30
Author(s):  
Gabriela Marian ◽  
Brânduşa Ecaterina Focşeneanu ◽  
George Stercu ◽  
Andrei-Cristian Bondar ◽  
Claudiu Pavel ◽  
...  
Keyword(s):  
Stroke Patient ◽  
Neurotrophic Factors ◽  
Cognitive Abilities ◽  
Post Stroke

scholarly journals Outcome and predictive factors in post-stroke seizures: A retrospective case-control study

Seizure ◽  
2018 ◽  
Vol 62 ◽  
pp. 11-16 ◽  
Author(s):  
Ramiro Castro-Apolo ◽  
Josephine F. Huang ◽  
Myrian Vinan-Vega ◽  
William O. Tatum
Keyword(s):  
Predictive Factors ◽  
Case Control Study ◽  
Case Control ◽  
Retrospective Case ◽  
Post Stroke ◽  
Control Study

scholarly journals Age-Dependent Association Between Elevated Homocysteine and Cognitive Impairment in a Post-stroke Population: A Prospective Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Shengnan Zhou ◽  
Jiahao Chen ◽  
Lin Cheng ◽  
Kaili Fan ◽  
Minjie Xu ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Impairment ◽  
Multivariate Regression Analysis ◽  
Logistic Regression Models ◽  
Post Stroke ◽  
Stroke Population ◽  
Age Dependent ◽  
Independent Association ◽  
A Prospective Study ◽  
State Examination

Background and Purpose: The results regarding the independent association between homocysteine (Hcy) levels and post-stroke cognitive impairment (PSCI) were inconsistent. The effect of age on this association has yet to be explored. This study aims to determine the relationship between Hcy levels, age, and cognitive impairment in a post-stroke population.Methods: A total of 592 patients with acute ischemic stroke (AIS) completed follow-up. Serum Hcy levels were measured enzymatically by spectrophotometry within 24 h of admission. Cognitive function was evaluated by the Mini-Mental State Examination (MMSE) 1 month after stroke, and the scores ≤ 24 were considered as cognitive impairment. Our study was dichotomized into two groups by a cut-off of 65 years. Multivariate logistic regression models were used to determine the association between baseline Hcy levels and cognitive impairment.Results: According to the MMSE score, 317 (53.5%) patients had cognitive impairment. Patients with higher levels of Hcy were more prone to have cognitive impairment 1 month after stroke than patients with lower levels of Hcy (p < 0.001). The optimal cut-off points of Hcy level (μmol/L) were (T1) ≤ 8, (T2) 8–12, and (T3) ≥ 12. After adjusting for confounding factors, the multivariate regression analysis showed that the third Hcy tertile was independently associated with cognitive impairment [odds ratio (OR) = 2.057, 95% confidence interval (CI) = 1.133–3.735, p = 0.018). A stronger association [T2 (OR = 2.266, 95% CI = 1.042–4.926, p = 0.039); T3 (OR =3.583, 95% CI = 1.456–8.818, p = 0.005)] was found in the younger group. However, the independent association was not confirmed in the older group.Conclusions: Elevated Hcy levels in the acute phase of ischemic stroke were independently associated with cognitive impairment in a post-stroke population. Furthermore, the association was age-dependent and more meaningful in a younger population aged below 65. So, Hcy levels in patients with stroke should be well-monitored, especially in younger patients.

scholarly journals SPECIFIC EDUCATIONAL INTERVENTIONS IN THE REHABILITATION OF COGNITIVE CAPACITIES OF ADULTS DUE TO A CEREBROVASCULAR ACCIDENT (EXPERIMENTAL INVESTIGATION)

World Science ◽  
2020 ◽  
Vol 3 (6(58)) ◽  
pp. 46-49
Author(s):  
Aurelia Glavan
Keyword(s):  
Experimental Investigation ◽  
Cognitive Abilities ◽  
Cerebrovascular Accident ◽  
Cognitive Rehabilitation ◽  
Social Inclusion ◽  
Cost Effective ◽  
Educational Interventions ◽  
Mediated Learning ◽  
Post Stroke ◽  
The Social

An optimal cognitive functionality ensures the efficiency of day-to-day activities and a person's integration into the socio-economic environment. Cognition is not a unitary concept, it incorporates several domains: attention, memory, executive functions, perception and praxis, language. Cognitive functions are affected as a result of a cerebrovascular accident (CVA), manifested by a prevalence of 20% to 80% after a stroke. We have proposed an experimental investigation - the use of the Reuven Feuerstein theory in the cognitive rehabilitation of post-stroke individuals, thus overcoming the social disadvantage and contributing to improving their quality of life, through social inclusion. The principle of mediated learning has proven to be effective in improving the cognitive abilities of post-stroke individuals in addition to medical treatment, representing an alternative service offered by the specialists in cognitive therapy, thus being a quick and cost-effective way of recovering.

scholarly journals Association among depression, cognitive impairment and executive dysfunction after stroke

2012 ◽  
Vol 6 (3) ◽  
pp. 152-157 ◽  
Author(s):  
Luisa Terroni ◽  
Matildes F.M. Sobreiro ◽  
Adriana B. Conforto ◽  
Carla C. Adda ◽  
Valeri D. Guajardo ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Neuropsychological Tests ◽  
Executive Dysfunction ◽  
Stroke Survivors ◽  
Stroke Patients ◽  
Adequate Treatment ◽  
Post Stroke ◽  
Quantitative Studies ◽  
Post Stroke Depression ◽  
The Relationship

ABSTRACT The relationship between depression and cognitive impairment, frequent after stroke, is complex and has not been sufficiently elucidated. Objective: To review the relationship between post-stroke depression and cognitive impairment. Methods: We performed a PubMed database search spanning the last ten years, using the terms post-stroke depression, cognitive dysfunction, cognitive impairment and neuropsychological tests. Our target studies were original quantitative studies that investigated the relationship between post-stroke depression (PSD) and cognitive impairment in stroke patients. Articles published in English, Spanish, Italian and Portuguese were considered. Selection criteria were the use of neuropsychological tests to assess cognitive function, and of either instruments to diagnose major depression, or scales to assess depressive symptoms, within the first three months after stroke. Results: Six original quantitative studies fulfilled the criteria. The prevalence of PSD within the first three months after stroke ranged from 22% to 31%. Incidence ranged from 25% to 27% and was evaluated in only two studies. PSD was associated with increased cognitive impairment. Cognitive impairment was reported in 35.2% to 87% of the patients. Post-stroke cognitive deficits were reported mostly in executive function, memory, language, and speed of processing. Conclusion: Executive dysfunction and depression occur in stroke survivors, are frequently coexistent, and also associated with worse stroke prognosis. Healthcare professionals need to address and provide adequate treatment for depression and executive dysfunctions in stroke patients early in the first three months after stroke. Future studies should evaluate the efficacy of programs evaluating the early detection and treatment of PSD and executive dysfunction in stroke survivors.

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