StrokeAHA SCIENTIFIC STATEMENTCognitive Impairment After Ischemic andHemorrhagic Stroke:A Scientific Statement Fromthe American Heart Association/American StrokeAssociationNada El Husseini,MD,MHSc,FAHA,Chair;Irene L.Katzan,MD,MS FAHA,Vice Chair;Natalia S.Rost,MD,MPH,FAHA;Margaret Lehman Blake,PhD,CCC-SLP;Eeeseung Byun,RN,PhD:Sarah T.Pendlebury,FRCP DPhil;Hugo J.Aparicia,MD,MPH;Maria J.Marquine,PhD;Rebecca F.Gottesman,MD,PhD,FAHA;Eric E.Smith,MD,MPH,FAHA;on behalf of the American HeartAssociation Stroke Council;Council on Cardiovascular and Stroke Nursing;Council on Cardiovascular Radiology and Intervention;Council on Hypertension;and Council on Lifestyle and Cardiometabolic HealthPURPOSE:Cognitive impairment is a common consequence of stroke and has direct implications for poststroke functioningand quality of life,including the ability to maintain a job,live independently,sustain interpersonal relationships,and drive avehicle.In this scientific statement,we critically appraise the literature on the prevalence,diagnosis,and management ofpoststroke cognitive impairment (PSCI)and provide a framework for clinical care while highlighting gaps that merit furtherstudy.METHODS:We performed a scoping literature review of randomized controlled clinical trials,prospective and retrospectivecohort studies,case-control studies,clinical guidelines,review articles,and editorials on the incidence and prevalence,naturalDownloadedhistory,diagnosis,and management of PSCl.Scoping reviews determine the scope of a body of literature on a given topic toindicate the volume of literature and the studies currently available and provide an overview of its focus.fromRESULTS:PSCI is common after stroke,especially in the first year,and ranges from mild to severe.Although cognitiveimpairment is reversible in some cases early after stroke,up to one-third of individuals with stroke develop dementia withinhttp:/5 years.The pathophysiology is not yet fully elucidated but is likely attributable to an acute stroke precipitating a series/ahajoof pathological events,often in the setting of preexisting microvascular and neurodegenerative changes.Screening forassociated comorbidities and interdisciplinary management are integral components of the care of individuals with PSCI.There is a need for prospective studies evaluating the individual trajectory of PSCI and the role of the acute vascular eventin the predisposition for Alzheimer disease and related dementias,as well as high-quality,randomized clinical trials focusedon PSCI management.Key Words:AHA Scientific Statements cognitive dysfunction depression prevalence prospective studies risk factors strokeost-stroke cognitive impairment (PSCI)ranges inafter stroke even in those with transient cognitiveseverity from mild to severe and occurs in up to 60%impairment.The American Heart Association/Ameri-of stroke survivors in the first year after stroke,withcan Stroke Association statement "Vascular Contribu-a higher rate seen shortly after
