12 Oct 20. Featured Paper

Link to paper on European Stroke Journal.

Authors

Joanna M Wardlaw, Fergus Doubal, Rosalind Brown, Ellen Backhouse, Lisa Woodhouse, Philip Bath, Terence J Quinn, Thompson Robinson, Hugh S Markus, Richard McManus, John T O’Brien, David J Werring, Nikola Sprigg, Adrian Parry-Jones, Rhian M Touyz, Steven Williams, Yee-Haur Mah, Hedley Emsley, the R4VaD Investigators

Abstract

Background: Stroke commonly affects cognition &, by definition, much vascular dementia follows stroke.

However, there are fundamental limitations in our understanding of vascular cognitive impairment, restricting understanding of prevalence, trajectories, mechanisms, prevention, treatment & patient-service needs.

Aims: Rates, Risks & Routes to Reduce Vascular Dementia (R4VaD) is an observational cohort study of post-stroke cognition.

We aim to recruit a wide range of patients with stroke, presenting to geographically diverse UK hospitals, into a longitudinal study to determine rates of, & risk factors for, cognitive & related impairments after stroke, to assess potential mechanisms & improve prediction models.

Methods: We will recruit at least 2000 patients within six weeks of stroke with or without capacity to consent & collect baseline demographic, clinical, socioeconomic, lifestyle, cognitive, neuropsychiatric & informant data using streamlined patient-centred methods appropriate to the stage after stroke.

We will obtain more detailed assessments at four to eight weeks after the baseline assessment & follow-up by phone & post yearly to at least two years.

We will assess diagnostic neuroimaging in all & high-sensitivity inflammatory markers, genetics, blood pressure & diffusion tensor imaging in mechanistic sub-studies.

Planned outputs: R4VaD will provide reliable data on long-term cognitive function after stroke, stratified by prior cognition, stroke- & patient-related variables & improved risk prediction.

It will create a platform enabling sharing of data, imaging & samples.

Participants will be consented for re-contact, facilitating future clinical trials & providing a resource for the stroke & dementia research communities.

Keywords

• Cognition

• Dementia

• Observational

• Stroke