Smoking clouds the brain after stroke

A study of stroke patients from Southern Ontario found those who smoke have more difficulty with problem-solving and decision-making than non-smokers.

The study, presented today at the Canadian Stroke Congress, tested mental abilities of 76 patients, including 12 smokers, with an average age of 67.5 years, using the Montreal Cognitive Assessment (MoCA) tool. The MoCA exam tests patients with memory and problem solving questions and gives them a score out of 30.

Smokers had a median MoCA score two points lower than non-smokers - 22 out of 30 compared to 24 out of 30. Patients who had previously quit smoking achieved the same scores as lifetime non-smokers, says Gail MacKenzie, a clinical nurse specialist at Hamilton General Hospital.

"This research emphasizes the importance of smoking cessation for people with stroke or TIA," says MacKenzie. TIA, or transient ischemic attack, is a mini stroke and often serves as a warning sign that a bigger stroke is imminent. "Smoking is a risk factor for cognitive impairment for people who continue to smoke and this ability to problem-solve and make decisions has implications for patients' health and self-management of care."

Low MoCA scores can reflect problems in memory, language, attention, visual-spatial or problem-solving skills.

The 10-minute MoCA test was administered to patients attending stroke prevention clinics in Barrie, Oshawa and Hamilton.

Almost 37,000 Canadians will die prematurely each year due to tobacco use, and almost one-third of these deaths will be from cardiovascular disease. Smoking contributes to the build up of plaque in the arteries, increases the risk of blood clots, reduces the oxygen in the blood, increases blood pressure and makes the heart work harder. Smoking also nearly doubles the risk of ischemic stroke. If a person stops smoking, their risk for stroke or heart disease decreases. Within 18 months to two years of quitting, the risks of stroke are about the same as for non-smokers.

"All Canadians should be smoke-free," says Ian Joiner, director of stroke for the Heart and Stroke Foundation. "Not only does it improve the length and quality of your life - but also the lives of those around you."

Joiner says this study reinforces the importance of tobacco-control legislation, prevention programs and education.

"There needs to be more effort to help people stop smoking to protect their brain both from stroke and from mental decline after stroke," says Dr. Mark Bayley, Congress Co-Chair.

The Canadian Stroke Congress is a joint initiative of the Canadian Stroke Network, Heart and Stroke Foundation of Canada and the Canadian Stroke Consortium.

It gathers more than 1,000 stroke professionals to discuss the latest breakthroughs in stroke research and care.

###