Predictors of Poststroke Cognitive Decline among Stroke Survivors in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

Abstract

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 poststroke cognitive decline among stroke survivors in Sub-Saharan Africa, these studies presented inconsistent findings. Hence, the review aimed to determine the pooled predictors of poststroke cognitive decline among stroke survivors in Sub-Saharan Africa.

Methods: The eligible 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 poststroke 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 poststroke cognitive decline.

Conclusions: Increased age, lower educational level, poor functional recovery, and left hemisphere stroke were the pooled independent predictors of poststroke 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.

Keywords: Cognitive decline; Meta-analysis; Poststroke cognitive decline; Stroke survivors; Sub-Saharan Africa.