An Extended Follow-up Of Stroke Patients For Cognitive Impairment And Neuropsychiatric Disorders: Sydney Stroke Study
Funder
National Health and Medical Research Council
Funding Amount
$321,800.00
Summary
Vascular Dementia (VaD) is the second most common cause of dementia after Alzheimer's disease. In fact, it may be a preventable cause of dementia. Yet it has been relatively neglected by researchers until the last decade, which has seen an upsurge of interest in this disorder. There is no consensus on the criteria for dementia. The profile of early cognitive impairment due to vascular factors is still poorly understood, and the longitudinal course of VaD as defined by modern criteria has not bee ....Vascular Dementia (VaD) is the second most common cause of dementia after Alzheimer's disease. In fact, it may be a preventable cause of dementia. Yet it has been relatively neglected by researchers until the last decade, which has seen an upsurge of interest in this disorder. There is no consensus on the criteria for dementia. The profile of early cognitive impairment due to vascular factors is still poorly understood, and the longitudinal course of VaD as defined by modern criteria has not been studied. There have been few studies of the progressive changes in MRI in patients with cerebrovascular disease. The overlap of VaD and Alzheimer's disease (AD) remains a problem for taxonomists and clinicians. One approach to the study of VaD is to examine a high risk group of subjects longitudinally to determine the early features, the risk factors and progressive changes. With this in mind, we began studying a cohort of stroke patients who are at high risk of VaD, in 1997-1999, and are following them longitudinally. The follow-up is now in its third year, and three neuropsychological assessments and two MRI-MRS scans have been performed. We propose to extend the follow-up to 5 years, with repeat neuropsychiatric, neuropsychological and MRI-MRS investigations, and wherever possible to necropsy, to determine the nature of vascular pathology that underlies cognitive impairment. Our cohort of stroke patients is arguably the most comprehensively assessed such cohorts internationally, and presents an excellent opportunity for a long-term follow-up study.Read moreRead less
THE NATURAL HISTORY OF COGNITIVE IMPAIRMENT AND DEMENTIA IN A STROKE COHORT
Funder
National Health and Medical Research Council
Funding Amount
$290,747.00
Summary
In a current NHMRC-funded study, we have examined 200 stroke patients (and 100 control subjects) at 3 months after a stroke and one year later, and identified those who have impairment in memory and other cognitive functions. We have also studied these subjects in detail from a psychiatric perspective and performed brain scans on them using magentic resonance imaging. We find that many stroke patients have problems with their cognitive functioning which has a major impact on their lives. A large ....In a current NHMRC-funded study, we have examined 200 stroke patients (and 100 control subjects) at 3 months after a stroke and one year later, and identified those who have impairment in memory and other cognitive functions. We have also studied these subjects in detail from a psychiatric perspective and performed brain scans on them using magentic resonance imaging. We find that many stroke patients have problems with their cognitive functioning which has a major impact on their lives. A large number also become depressed. These consequences of stroke are not given sufficient importance by clinicians. The fact that stroke is a common problem in the elderly, and our society is aging, makes this a problem of major public health significance. In the new proposal, we plan to study these subjects up to 3 years with repeat neuropsychiatric assessments and brain scans to investigate the natural history of stroke-related cognitive impairment. We will determine whether further new cases of dementia develop in the period 1-3 years, what happens to the brain lesions picked up on brain scans, and how these deficiencies affect the patients' living status and their longevity. We will be able to determine the factors that lead to a good outcome, and suggest strategies that may be applicable to improve the functioning of these individuals.Read moreRead less
A philosophical and empirical approach to the nature of perception and belief. This project offers substantial benefits - intellectual, practical, and ultimately economic - to the nation. On the intellectual side, the project will contribute to research output and will further enhance the national research strength in the study of delusions, rationality, and agency, within both philosophy of mind and inter-disciplinary cognitive science. On the practical side, the project offers the prospect of ....A philosophical and empirical approach to the nature of perception and belief. This project offers substantial benefits - intellectual, practical, and ultimately economic - to the nation. On the intellectual side, the project will contribute to research output and will further enhance the national research strength in the study of delusions, rationality, and agency, within both philosophy of mind and inter-disciplinary cognitive science. On the practical side, the project offers the prospect of considerable benefits for the community as improved theories of the nature and causes of delusions generate strategies for earlier detection or even prevention of the development of delusions, new methods of therapy for patients, and better understanding for families.Read moreRead less
Normal and abnormal processes of social attention orienting. Human beings are capable of rapidly detecting the direction of another person's eye-gaze and shifting attention reflexively in that direction. This project will compare shifts of attention to non-social and social cues of direction to determine whether attentional shifts to gaze-direction are fast because humans are biologically hard-wired to respond to social cues of evolutionary significance (eyes) or because humans are well-practice ....Normal and abnormal processes of social attention orienting. Human beings are capable of rapidly detecting the direction of another person's eye-gaze and shifting attention reflexively in that direction. This project will compare shifts of attention to non-social and social cues of direction to determine whether attentional shifts to gaze-direction are fast because humans are biologically hard-wired to respond to social cues of evolutionary significance (eyes) or because humans are well-practiced at using a number of different signals for direction in their environment. Findings from this work will than be used to investigate whether a selective impairment of responding to gaze-direction contributes to the social impairments so characteristic of people with schizophrenia.
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