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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]

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posted on 09.12.2021, 16:19 authored by Jefrey Shumba, Affraic McLoughlin, Lamorna Browne, Alenka Schmid, Maev-Ann Wren, Anne HickeyAnne Hickey, Peter Kelly, Kathleen BennettKathleen Bennett, Daniela Rohde, Eithne SextonEithne Sexton

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.

Funding

Health Research Board Ireland [ICE-2015-1048]

History

Comments

The original article and an updated version may be available on https://hrbopenresearch.org

Published Citation

Shumba 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 Date

26 May 2020

Department/Unit

  • Data Science Centre
  • Health Psychology

Research Area

  • Population Health and Health Services

Publisher

F1000 Research Ltd

Version

  • N/A