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Confused Old Man

Covert Stroke After Surgery May Double Risk of Cognitive Decline


A covert stroke doesn’t cause any obvious immediate physical damage and doesn’t affect muscle or motor skills. Instead, it weakens connections necessary for executive functions such as memory, navigation, planning, decision-making and reasoning. Covert strikes occur five times as often as overt strokes. A new study has found that covert strokes are common in mature adults after elective, non-cardiac surgery, and that they may double the risk of cognitive decline.





For their study, the researchers conducted the NeuroVISION study, which was performed in 12 academic centers in 9 countries. Participants included 1,114 people aged 65 or older who had elective, non-cardiac surgery. All the participants had an MRI within 9 days of their surgery to look for evidence of a covert stroke. They were followed for one year, and their cognitive capabilities were assessed.





The researchers found that 7% of the participants had a covert stroke following elective, non-cardiac surgery. Cognitive decline occurred one year later in 42% of them, compared to in 29% of participants who did not have a covert stroke. Those who had a covert stroke were also more likely to experience perioperative delirium, overt stroke, or transient ischemic attack within one year of surgery.





The study was conducted primarily by researchers from McMaster
University and the University of Western Ontario. It was published online ahead
of print on August 15, 2019 in The
Lancet
.


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