Journal Article
Systematic Review
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Predictors of post-stroke cognitive decline among stroke survivors in Sub-Saharan Africa: A systematic review and meta-analysis.

INTRODUCTION: Stroke is a devastating medical disorder associated with significant morbidity and mortality among adults and the elderly worldwide. Although numerous primary studies have been conducted to determine the pooled predictors of post-stroke cognitive decline among stroke survivors in Sub-Saharan Africa, these studies presented inconsistent findings. Hence, the review aimed to determine the pooled predictors of post-stroke cognitive decline among stroke survivors in Sub-Saharan Africa.

METHODS: The eligible primary studies were accessed through Google Scholar, Scopus, PubMed, and Web of Science databases. A manual search of the reference lists of included studies was performed. A weighted inverse-variance random-effects model was used to determine the pooled predictors of post-stroke cognitive decline among stroke survivors in Sub-Saharan Africa.

RESULTS: A total of 1,710 stroke survivors from 10 primary studies were included in the final meta-analysis. Increased age (≥45 years) [Adjusted Odds Ratio (AOR)=1.32, 95%CI: 1.13, 1.54], lower educational level [AOR=4.58, 95%CI: 2.98, 7.03], poor functional recovery [AOR=1.75, 95%CI: 1.42, 2.15], and left hemisphere stroke [AOR=4.88, 95%CI: 2.98, 7.99] were significantly associated with post-stroke cognitive decline.

CONCLUSIONS: Increased age, lower educational level, poor functional recovery, and left hemisphere stroke were the pooled independent predictors of post-stroke cognitive decline in Sub-Saharan Africa Healthcare providers and other concerned bodies should give attention to these risk factors as the early identification may help to improve the cognitive profile of stroke survivors.

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