Cognitive Disorders and Apraxia
Keywords:Cognitive impairment, dementia, delirium, apraxia, attention, memory, executive function, problem-solving, multimodal interventions, TENS, music listening, exercise, rTMS, tDCS, electrical stimulation, ASA, depression, pharmacotherapy
According to the Canadian Study of Health and Aging (CSHA), it is estimated that 5% of all people over the age of 65 years have evidence of vascular cognitive impairment (Rockwood et al. 2000). The risk for cognitive impairment or decline is augmented by a history of stroke. As many as two-thirds of patients experience cognitive impairment or decline following stroke and approximately 1/3 develop dementia. Risk for developing dementia may be up to 10 times greater among individuals with stroke than for those without.
In this review, we examine issues around the definition, prevalence and natural history of post-stroke cognitive impairment as well as its clinical consequences. Risk factors for cognitive impairment are reviewed and the association between the treatment of hypertension and prevention of cognitive decline and dementia is explored. Identified treatment interventions include cognitive rehabilitation strategies (for the remediation of attention, memory, and executive functioning and problem-solving), electroacupuncture and TENS, music listening and pharmacotherapy. Reviews of the impact, risk factors, clinical consequences and treatment of both delirium and apraxia post-stroke are also provided.
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