Interventions to reduce cognitive decline post-stroke: an umbrella review

Introduction

Post-stroke cognitive impairment (PSCI) remains a common problem that can lead to significant disability and dependency. Previous work suggested that methodologically robust trials were lacking and that there is continued uncertainty on the benefits and limitations of pharmacological and non-pharmacological interventions. This umbrella review aims to update and synthesise evidence on pharmacological and non-pharmacological interventions for PSCI. Patients and methods: This review was pre-registered on PROSPERO (CRD42024611909) with searches from 2019 to 2024. Eligible studies were systematic reviews (SRs) of randomised controlled trials (RCTs) evaluating pharmacological or non-pharmacological interventions in adult stroke survivors (≥18 years) of any severity and reporting change in global cognition (eg, Mini-Mental State Examination). AMSTAR2 was used for risk of bias.