A common problem for stroke survivors is impaired cognition, for example difficulty thinking and remembering. It is not clear what we can do to protect cognitive function in stroke survivors. High blood lipid levels and clogged arteries (atherosclerosis) may contribute to cognitive problems post-stroke. Therefore, statins, a class of drugs used for lipid-lowering, may have a protective role. However, whether blood lipids, artery blockage, and statin use after stroke is associated with post-stroke cognitive function has yet to be confirmed. This study intends to explore whether these factors are linked to cognitive problems after stroke. This work is relevant to all stroke survivors in the UK and internationally and may inform primary health care practice and future research in this area.
Post-stroke dementia/cognitive impairment (PSD/PSCI) is common among stroke survivors. There is some observational evidence suggesting that blood lipids and atherosclerosis may be associated with PSD/PSCI, but direct and robust evidence for such associations remains scarce. Limited evidence from randomised controlled trials also indicates the potential for statins use to decrease the risk of PSD/PSCI. The aim of this study is to explore whether blood lipids and atherosclerosis are associated with PSD/PSCI in large representative populations and whether statin treatment appears to reduce this risk.
We will construct a retrospective cohort of adults with first stroke from the Clinical Practice Research Datalink (CPRD). Eligible patients will have no recorded diagnosis of pre-stroke dementia or cognitive impairment. Exposures will be the baseline blood lipids (including total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglyceride), atherosclerosis and the use of statins. Outcome of interest will be the time between first stroke and dementia. Descriptive analysis and modelling analysis will be conducted, followed by several sensitivity analyses. We will adjust the effects of possible confounders and time-varying effects in the analysis.
Zhirong Yang - Chief Investigator - University of Cambridge
Zhirong Yang - Corresponding Applicant - University of Cambridge
Carol Brayne - Collaborator - University of Cambridge
Darren Toh - Collaborator - Harvard University
Duncan Edwards - Collaborator - University of Cambridge
Efthalia (Lina) Massou - Collaborator - University of Cambridge
Jonathan Mant - Collaborator - University of Cambridge
Stephen Burgess - Collaborator - University of Cambridge
HES Admitted Patient Care;ONS Death Registration Data;Patient Level Index of Multiple Deprivation;Practice Level Index of Multiple Deprivation