A qualitative study investigating the views of stroke survivors and their family members on discussing post-stroke cognitive trajectories

\ua9 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.Cognitive impairment is common early after stroke but trajectories over the long term are variable. Some stroke survivors make a full recovery, while others retain a stable impairment or decline. This study explored the perceived advantages and disadvantages of discussing potential cognitive trajectories with stroke survivors and their family members. Stroke survivors at least six-months post-stroke were purposively sampled from an existing pool of research volunteers recruited originally for the OCS-Recovery study. They were invited, alongside a family member, to participate in a semi-structured interview. Interviews were audio recorded, transcribed, and analyzed using reflexive thematic analysis. Twenty-six stroke survivors and eleven family members participated. We identified one overarching theme and three related subthemes. The overarching theme was: One size does not fit all. The subthemes were: (1) Hearing about potential cognitive trajectories helps to develop realistic expectations; (2) Discussions about cognitive trajectories may be motivating; (3) Cognitive decline and post-stroke dementia discussions may be anxiety-provoking and depressing. Healthcare professionals should adopt a person-centred approach to sharing information about post-stroke cognitive trajectories. Discussions should be tailored to individual needs and preferences, with dementia-related topics in particular addressed with the utmost selectivity and sensitivity

Early intervention for psychotic disorders: Real-life implementation in Hong Kong

Hong Kong is among the first few cities in Asia to have implemented early intervention for psychosis in 2001. Substantial changes in psychosis service have since taken place. We reviewed available outcome data in Hong Kong, with reference to the philosophy of early intervention in psychosis, discussing experience and lessons learned from the implementation process, and future opportunities and challenges. Data accumulated in the past decade provided evidence for the benefits and significance of early intervention programmes: patients under the care of early intervention service showed improved functioning, milder symptoms, and fewer hospitalizations and suicides. Early intervention is more cost-effective compared with standard care. Stigma and misconception remains an issue, and public awareness campaigns are underway. In recent years, a critical mass is being formed, and Hong Kong has witnessed the unfolding of public service extension, new projects and organizations, and increasing interest from the community. Several major platforms are in place for coherent efforts, including the public Early Assessment Service for Young people with psychosis (EASY) programme, the Psychosis Studies and Intervention (PSI) research unit, the independent Hong Kong Early Psychosis Intervention Society (EPISO), the Jockey Club Early Psychosis (JCEP) project, and the postgraduate Psychological Medicine (Psychosis Studies) programme. The first decade of early intervention work has been promising; consolidation and further development is needed on many fronts of research, service and education. © 2012 Elsevier B.V.postprin

Risk Prediction Models for Post-Stroke Dementia

A strong association exists between stroke and dementia with both diseases linked to ageing. Survival rates from stroke are improving which would equate to an ever-expanding population of patients at risk of future dementia. Early or timelier identification of dementia has become a priority in many countries, including the UK. Although screening for dementia is not advocated, targeting at risk populations could be used to reduce an individual’s risk via intervention (i.e., personalised medicine), where available. One approach to improving identification of high-risk dementia individuals is using risk prediction models. Such models could be applied to stroke survivors. Dementia risk prediction models specific to stroke survivors have recently been developed and will be discussed her

Identifying Challenges Related to the Management of Comorbidities in People with Dementia in Residential Care: Expert Delphi Consensus Exercise

\ua9 The Author(s) 2025. Improving early detection, management, and treatment of comorbid conditions to dementia in residential care could slow down cognitive and functional decline, and increase residents’ quality of life. We conducted a Delphi study comprising three rounds (two surveys and an interview) to identify the most difficult dementia comorbidities to deal with in residential care and related issues. Participants were 15 UK-based experts including academics, residential care workers, geriatricians, and neuropsychologists. In the first-round of the Delphi, experts mentioned 15 comorbid health conditions to dementia and 19 issues. In the following rounds of the Delphi mental illnesses, delirium, and sensory impairments were identified as the most difficult comorbidities to dementia to deal with. Medication management, symptom management, shortage of staff, lack of training among staff, and limited resources from the broader healthcare system were identified as the most difficult issues when dealing with dementia comorbidities

The mini-Oxford cognitive screen (Mini-OCS): A very brief cognitive screen for use in chronic stroke

\ua9 European Stroke Organisation 2025. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). Introduction: No stroke-specific cognitive screen currently exists for community-dwelling chronic stroke survivors, with primary care and community settings relying on dementia tools which often do not consider specific post-stroke impairments. The Oxford Cognitive Screen (OCS) was developed for use in acute stroke, but its administration time is prohibitive for brief screening. Here, we aimed to develop, standardise and psychometrically validate the Mini-Oxford Cognitive Screen (Mini-OCS), a brief (<8 min) cognitive screen aimed for use in chronic stroke. Method: Existing full OCS data for 464 English participants who were ⩾6 months post-stroke were analysed for the possibility of a short-form. Theoretical choices were made to adapt the short-form to be suitable for use in chronic stroke. The Mini-OCS was then completed by 164 neurologically healthy controls (Mage = 68.66; SD = 12.18, Myears of education 15.40; SD = 3.64, 61% female), and 89 chronic stroke survivors (Mage = 69.86; SD = 14.83, Myears education = 14.29; SD = 4.01, 44.94% female, Mdays since stroke = 597.02; SD = 881.12, 78.57% ischaemic, Median NIHSS = 6.5 (IQR = 4–11)). In addition, the original OCS, the Montreal Cognitive Assessment, and an extended neuropsychological battery were administered. Psychometric properties of the Mini-OCS were evaluated via construct validity and retest reliability. Findings: Normative data for the Mini-OCS is provided and known-group discrimination demonstrates increased sensitivity in the memory and executive function domains compared to the OCS. The Mini-OCS further met all appropriate benchmarks for evidence of retest reliability and construct validity. Discussion and conclusion: The Mini-OCS is a short-form standardised cognitive screening tool with initial evidence of good psychometric properties for use in a chronic stroke population

Disease-Specific Risk Models for Predicting Dementia: An Umbrella Review

\ua9 2024 by the authors. Dementia is a leading cause of disability and death globally. Individuals with diseases such as cardiovascular, cardiometabolic and cerebrovascular disease are often at increased dementia risk. However, while numerous models have been developed to predict dementia, they are often not tailored to disease-specific groups. Yet, different disease groups may have unique risk factor profiles and tailored models that account for these differences may have enhanced predictive accuracy. In this review, we synthesise findings from three previous systematic reviews on dementia risk model development and testing to present an overview of the literature on dementia risk prediction modelling in people with a history of disease. Nine studies met the inclusion criteria. Currently, disease-specific models have only been developed in people with a history of diabetes where demographic, disease-specific and comorbidity data were used. Some existing risk models, including CHA2DS2-VASc and CHADS2, have been externally validated for dementia outcomes in those with atrial fibrillation and heart failure. One study developed a dementia risk model for their whole population, which had similar predictive accuracy when applied in a sub-sample with stroke. This emphasises the importance of considering disease status in identifying key predictors for dementia and generating accurate prediction models for dementia

Foods, dietary patterns, and risk of vascular dementia: a systematic review

\ua9 The Author(s) 2024. Background: Vascular dementia (VaD) is the second most common cause of dementia globally and is associated with a significant economic and social burden. Diet could represent an important tractable risk factor for VaD. We synthesised current evidence on associations between consumption of specific foods or dietary patterns and VaD risk. Methods: Five databases were searched from inception to January 2024 for prospective cohort studies exploring associations between individual foods or dietary patterns and incident VaD. Results: Sixteen studies were included. Compared with low intake reference groups, higher fruit and vegetable intake, moderate alcoholic drink intake (1–3 drinks/day), higher tea and coffee intake, and following a plant-based dietary pattern were associated with lower VaD risk. Conversely, moderate fried fish intake (0.25–2 servings/week), higher ultra-processed food intake (especially intake of sweetened beverages) and higher processed meat intake (≥ 2 servings/week) were associated with increased VaD risk. Inconsistent findings were observed for other dietary exposures. Discussion: A healthy diet could lower VaD risk. However, evidence is characterised by a limited number of studies for specific dietary exposures. Further research is needed to inform personalised and population-based approaches to lower VaD risk

Foods, dietary patterns, and risk of vascular dementia: a systematic review

Background: Vascular dementia (VaD) is the second most common cause of dementia globally and is associated with a significant economic and social burden. Diet could represent an important tractable risk factor for VaD. We synthesised current evidence on associations between consumption of specific foods or dietary patterns and VaD risk. Methods: Five databases were searched from inception to January 2024 for prospective cohort studies exploring associations between individual foods or dietary patterns and incident VaD. Results: Sixteen studies were included. Compared with low intake reference groups, higher fruit and vegetable intake, moderate alcoholic drink intake (1–3 drinks/day), higher tea and coffee intake, and following a plant-based dietary pattern were associated with lower VaD risk. Conversely, moderate fried fish intake (0.25–2 servings/week), higher ultra-processed food intake (especially intake of sweetened beverages) and higher processed meat intake (≥ 2 servings/week) were associated with increased VaD risk. Inconsistent findings were observed for other dietary exposures. Discussion: A healthy diet could lower VaD risk. However, evidence is characterised by a limited number of studies for specific dietary exposures. Further research is needed to inform personalised and population-based approaches to lower VaD risk