Association of blood lipids, atherosclerosis and statins treatment with post-stroke cognitive impairment and dementia: a systematic review protocol
Zhirong Yang, Hanyuying Wang, Duncan Edwards, Carol Brayne, Jonathan Mant
Systematic review: PSD is common among stroke survivors: it occurs in about 10% of the survivors after first stroke and about 30% after recurrent stroke, with the prevalence ranging from 7% to 67%, depending on the population and diagnosis criteria. There is some observational evidence suggesting that blood lipids and atherosclerosis are associated with cognitive decline and dementia in general population. However, substantial uncertainty about such association exists in the stroke survivors. Randomised evidence is also very limited for the effect of statins (the first-line lipid-lowering treatment) on preventing PSCI/PSD. We will include cohort study and randomised controlled trial, regardless of study time, location, settings, data sources, sample size, study quality, length of follow-up, confounders adjusted and publication language. While we include RCTs mainly for the third objective, if the association of blood lipids and atherosclerosis (recorded at baseline before the start of the assigned treatments) with PSCI/PSD was explored using data from RCTs, we will regard this kind of study as cohort study because blood lipids and atherosclerosis would not be the factor to randomise in a trial and the analysis for this association would still be observational.