Systematic review and meta-analysis of the effect of cognitive impairment on the risk of admission to long-term care after stroke [version 1; peer review: 1 approved, 1 approved with reservations]
Introduction: Admission to long-term care (LTC) post-stroke can be a significant source of costs. Studies evaluating the effect of cognitive impairment (CI) and dementia on risk of LTC admission post-stroke have not been systematically reviewed. The aim of this paper was to conduct a systematic review and meta-analysis of studies of the association between post-stroke CI/dementia and admission to LTC.
Patients and methods: PubMed, PsycInfo and Cumulative Index to Nursing
and Allied Health Literature (CINAHL) databases were searched for peer-review
articles in English published January 2000-June 2018. Included studies were
population-based or hospital-based studies assessing the relationship between
CI or dementia, and admission to LTC post-stroke. Abstracts were screened,
followed by full-text review of potentially relevant articles. Relevant data
was extracted using a standard form and the Crowe Critical Appraisal Tool was
used for quality appraisal. Results were pooled using random-effects
meta-analysis and heterogeneity was assessed using the I² statistic.
Results: 18 articles were included in the review and
12 in a meta-analysis. 14/18 studies adjusted for covariates including
functional impairment. Increased odds of admission to LTC was associated with
post-stroke CI [Odds Ratio (CI 95%): 2.36 (1.18, 4.71), I²=77%] and post-stroke
dementia [Odds Ratio (CI 95%): 2.58 (1.38 to 4.82), I²=60%].
Discussion and conclusion: Post-stroke CI and dementia increase odds of admission to LTC
post-stroke, independent of functional impairment. This indicates the potential
for interventions that reduce post-stroke CI and dementia to also reduce risk
of admission to LTC post-stroke, and ultimately costs.
Health Research Board Ireland [ICE-2015-1048]
CommentsThe original article and an updated version may be available on https://hrbopenresearch.org
Published CitationShumba J. et al. Systematic review and meta-analysis of the effect of cognitive impairment on the risk of admission to long-term care after stroke [version 1; peer review: 1 approved, 1 approved with reservations]. HRB Open Res 2020;3:28
Publication Date26 May 2020
- Data Science Centre
- Health Psychology
- Population Health and Health Services
PublisherF1000 Research Ltd