London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 825 905 Meta-analysis and reviews Association between asymptomatic carotid stenosis and cognitive function: a systematic review X.L. Chang1, H.Q. Zhou2, C.Y. Lei3, B. W4, Y.C. Chen5, Z.L. Hao6, W. Dong7, M. Liu8 Department of Neurology, West China Hospital, Sichuan University, Chengdu, CHINA1, De-partment of Neurology, West China Hospital, Sichuan University, Chengdu, CHINA2, Department of Neurology, West China Hospital, Sichuan University, Chengdu, CHINA3, Department of Neurology, West China Hospital, Sichuan University, Chengdu, CHINA4, Department of Neurology, West China Hospital, Sichuan University, Chengdu, CHINA5, Department of Neurology, West China Hospital, Sichuan University, Chengdu, CHINA6, Department of Neurology, West China Hospital, Sichuan University, Chengdu, CHINA7, Department of Neurology, West China Hospital, Sichuan University, Chengdu, CHINA8, Chengdu,CHINA9 Background: Asymptomatic carotid stenosis (CS), defined as that patients have carotid stenosis without a past history and current clinical evidence of any prior cerebrovascular event, have tradi-tionally been considered clinically silent. It is less clear whether an asymptomatic CS itself is an in-dependent risk factor for a cognitive impairment. Methods: We conducted a systematic review of the literature using the Cochrane Library, MED-LINE, EMBASE and the China National Knowledge Infrastructure database. We also searched the reference lists of relevant studies and review articles. Two reviewers used a standardised form to collect data and assess eligibility. The quality of study was assessed by the Newcastle–Ottawa Scale. Results: A total of ten studies comprising 763 participants in the CS group and 6308 in the non-CS group were included. All studies but one support the association between asymptomatic CS and cog-nition impairment. When examining the concomitant factors of asymptomatic carotid stenosis and cognition in seven eligible studies, age (two studies) and reduced cerebrovascular reactivity (two studies) showed positive results associated with cognitive impairment. Conclusions: These results suggest that rather than being clinically silent, asymptomatic carotid ste-nosis may be associated with cognitive function impairment, which need to be further investigated with high-quality studies. 906 Meta-analysis and reviews Adjusting after stroke: A systematic review and synthesis of qualitative studies S. Sarre1, C. Redlich2, A. Tinker3, E. Sadler4, A. Bhalla5, C. McKevitt6 King’s College London, London, UNITED KINGDOM1, University of Brighton, Brighton, UNITED KINGDOM2, King’s College London, London, UNITED KINGDOM3, King’s College London, London, UNITED KINGDOM4, Guy’s & St Thomas’ NHS Foundation Trust, London, UNITED KINGDOM5, King’s College London, London, UNITED KINGDOM6 Background: There is evidence of variation in longer-term mental health and wellbeing after stroke, which is not completely explained by severity or level and type of disability. The way people adjust to the consequences of stroke may be a factor. Stroke survivors’ own views on adjusting after stroke have been captured in qualitative studies. A systematic review and synthesis of such studies was conducted, in order to understand adjustment and the barriers and facilitators to it. Methods: Qualitative studies drawing on stroke survivor’s accounts of their recovery and adjust-ment, published in peer reviewed journals from 1990 – 2011 were searched for in databases CI-NAHL, SSCI, Medline, ASSIA and Psychinfo, and by hand-searching relevant systematic reviews. Papers were quality assessed for credibility and contribution using published criteria. Findings from included studies were systematically extracted using a data matrix, and synthesised thematically. Results: Forty of 692 studies were included. Reported impacts of stroke were on physical function-ing, relationships and sense of self, with interactions between these domains. Adjustment to these changes had practical and psychosocial elements. It was not a linear process, but often marked by set-backs and new challenges over time. Participants identified personal characteristics such as de-termination as key to adjustment, but also employed practical and mental strategies. Their accounts suggest that relationships (including relationships with health care professionals) and structural fac-tors (such as access to health services, employment possibilities and welfare systems) influenced ef-forts to adjust after stroke. Conclusions: Processes of adjustment draw on resources found at the personal, inter-personal and structural levels. Adjustment usually continues long after discharge from services. Some stroke sur-vivors may benefit from more explicit professional support to develop strategies for adjustment in the long term.
Karger_ESC London_2013
To see the actual publication please follow the link above