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Editorial| Volume 26, ISSUE 3, P301-303, March 2018

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Post-Stroke Cognitive Impairment, Depression and Apathy: Untangling the Relationship

  • Perminder S. Sachdev
    Correspondence
    Send correspondence and reprint requests to Dr Perminder S. Sachdev, NPI Euroa Centre, Prince of Wales Hospital, via Gate 6, Avoca St, Randwick, NSW 2031, Australia.
    Affiliations
    Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia

    Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, NSW, Australia
    Search for articles by this author
Published:December 11, 2017DOI:https://doi.org/10.1016/j.jagp.2017.12.002
      Neurobehavioral researchers have long decried the neglect of the neuropsychiatric consequences of stroke in favor of the classical emphasis on motor and speech deficits.
      • Chemerinski E.
      • Robinson R.G.
      The neuropsychiatry of stroke.
      In the last three decades, the situation has steadily changed, with increasing emphasis on post-stroke cognitive impairment
      • Mijajlović M.D.
      • Pavlović A.
      • Brainin M.
      • et al.
      Post-stroke dementia—a comprehensive review.
      and depression.
      • Towfighi A.
      • Ovbiagele B.
      • El Husseini N.
      • et al.
      Poststroke depression: a scientific statement for healthcare professionals from the American Heart Association/American Stroke Association.
      Much less attention has been paid to apathy, which occurs about as frequently as cognitive impairment and depression after stroke,
      • van Dalen J.W.
      • Moll van Charante E.P.
      • Nederkoorn P.J.
      • et al.
      Poststroke apathy.
      and has a major impact on both the patient and their significant other.
      • Mayo N.E.
      • Fellows L.K.
      • Scott S.C.
      • et al.
      A longitudinal view of apathy and its impact after stroke.
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      Linked Article

      • Baseline Vascular Cognitive Impairment Predicts the Course of Apathetic Symptoms After Stroke: The CASPER Study
        The American Journal of Geriatric PsychiatryVol. 26Issue 3
        • Preview
          Apathy and depression are frequent neuropsychiatric symptoms after stroke, with prevalences ranging from 28% to 40%,1,2 and both are associated with poor quality of life3,4 and long-term prognosis.5 Cross-sectional studies have indicated that vascular cognitive impairment (VCI) is associated with poststroke depression (PSD),6 and according to longitudinal studies VCI also predicts long-term depressive symptoms.7–10 VCI is frequent after stroke, ranging from mild cognitive impairment to dementia, and is highly age-related, with an overall prevalence of 22% up to 15 years after stroke.
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