Terence J Quinn

University of Glasgow | UofG · School of Cardiovascular and Metabolic Health

Older people often present to healthcare services with acute and chronic problems that act together to adversely affect function. A common pathway comprises functional decline, followed by loss of independence and need for institutional care. However, this process is not necessarily inevitable or irreversible. Timely recognition of functional diffi...

Objective: Despite recent high-profile advances in our understanding of rehabilitation post-stroke, the evidence base remains weaker than in other areas of stroke management. Under the aegis of the European Stroke Organisation a select committee was assembled to collate and appraise the evidence base for rehabilitation interventions. Methods: Fo...

Background: frailty is common in older adults and associated with poor outcomes following illness. Although stroke is predominantly a disease of older people, our knowledge of frailty in stroke is limited. We aimed to collate the literature on acute stroke and frailty to estimate the prevalence of pre-stroke frailty and its associations with outco...

Introduction The optimal management of post stroke cognitive impairment remains controversial. These joint European Stroke Organisation (ESO) and European Academy of Neurology (EAN) guidelines provide evidence-based recommendations to assist clinicians in decision making around prevention, diagnosis, treatment, and prognosis. Methods Guidelines we...

Background: Many millions of people living with dementia around the world are not diagnosed, which has a negative impact both on their access to care and treatment and on rational service planning. Telehealth - the use of information and communication technology (ICT) to provide health services at a distance - may be a way to increase access to sp...

Background Prolonged cardiac monitoring (PCM) increases atrial fibrillation detection after stroke (AFDAS) but access is limited. We aimed to assess the utility of midregional pro-atrial natriuretic peptide (MR-proANP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) to identify people who are unlikely to have AFDAS and improve healthcare...

Importance Published data about the impact of poststroke seizures (PSSs) on the outcomes of patients with stroke are inconsistent and have not been systematically evaluated, to the authors’ knowledge. Objective To investigate outcomes in people with PSS compared with people without PSS. Data Sources MEDLINE, Embase, PsycInfo, Cochrane, LILACS, LI...

Background The serious outcomes of outbreaks of COVID-19 in care homes have been described internationally. The experiences of professionals working through outbreaks has received less attention, missing opportunities to acknowledge and learn lessons. Our aim was to explore the experiences of care home staff in Scotland of managing COVID-19 within...

Background Whilst anti-coagulation is typically recommended for thromboprophylaxis in atrial fibrillation (AF), it is often never prescribed, or prematurely discontinued, due to concerns regarding bleeding risk. The aim of this study was to assess both stroke/systemic embolism (SSE) and bleeding risk, comparing people with AF who continue anticoagu...

Background and Objective Epilepsy may result from various brain injuries, including stroke (ischemic and hemorrhagic), traumatic brain injury, and infections. Identifying shared common biological pathways and biomarkers of the epileptogenic process initiated by the different injuries may lead to novel targets for preventing the development of epile...

Purpose: Stroke survivors often live with significant treatment burden yet our ability to examine this is limited by a lack of validated measurement instruments. We aimed to adapt the 60-item, 12-domain Patient Experience with Treatment and Self-Management (PETS) (version 2.0, English) patient-reported measure to create a stroke-specific measure (...

Introduction: Frailty is common in patients with atherosclerotic disease and is associated with substantially increased morbidity, mortality and significant economic and resource implications. Major limb amputation (MLA) secondary to critical limb threatening ischaemia (CLTI) is also associated with high mortality rates. This study aims to examine...

Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Chief Scientist Office Background Atrial fibrillation (AF) related stroke risk can be reduced with oral anticoagulants (OACs). OACs need to be taken once or twice a day to maintain effectiveness but non-adherence remains a challenge mH...

Background and aims Frailty is a clinical syndrome of increased vulnerability to stressors, associated with adverse outcomes after stroke, but its impact on outcomes after transient ischaemic attack (TIA) remain unclear. Methods Retrospective analysis of 1185 patients referred by the emergency department (ED) who attended TIA clinic with a Clinica...

Background There is increasing interest in the concept of frailty in stroke, including both physical frailty and imaging-evidence of brain frailty. We aimed to establish the prevalence of brain frailty in stroke survivors as well as the concurrent and predictive validity of various frailty measures against long-term cognitive outcomes. Methods We...

Purpose: We performed a systematic review to assess the psychometric properties of extended Activities of Daily Living (eADL) scales. Materials and methods: Articles assessing eADL scales' properties were retrieved by searching multidisciplinary databases, and reference screening. Data on the following properties were extracted: validity, reliab...

Aim: This study aimed to investigate the association between the LE8 score and incident all-cause dementia (including Alzheimer's disease [AD] and vascular dementia) in UK Biobank. Methods: 259,718 participants were included in this prospective study. Smoking, non-HDL cholesterol, blood pressure, body mass index, HbA1c, physical activity, diet,...

Background: Blood Pressure Variability (BPV) is associated with cardiovascular risk and serum uric acid level. We investigated whether BPV is lowered by allopurinol and whether it is related to markers of cerebral small vessel disease. Methods: We used data from a randomised, double-blind, placebo-controlled trial of two years allopurinol treatment...

Objective: The primary objective was to develop a Swedish short version of the Montreal Cognitive Assessment (s-MoCA-SWE) for use with patients with stroke. Secondary objectives were to identify an optimal cut-off value for the s-MoCA-SWE to screen for cognitive impairment and to compare its sensitivity with that of previously developed short form...

Background: Older people are often explicitly or implicitly excluded from research, in particular clinical trials. This means that study findings may not be applicable to them, or that older people may not be offered treatments due to an absence of evidence. Aims: The aim of this work was to develop recommendations to guide all research relevant...

Background The serious outcomes of outbreaks of COVID-19 in care homes have been described internationally. The experiences of professionals working through outbreaks has received less attention, missing opportunities to acknowledge and learn lessons. Our aim was to explore the experiences of care home staff in Scotland of managing COVID-19 within...

Objective: To conduct a systematic review of biofluid biomarkers to test their association with the risk of post-CNS insult epilepsy. Background: It remains unknown if there are shared common biological pathways of an epileptogenic mechanism associated with a range of cerebral insults i.e., stroke, traumatic brain injury, and infections; and if cer...

Objective: To examine existing evidence on the effect of bilingualism on cognitive outcomes in the stroke population. Introduction: Stroke is associated with an increased risk of vascular cognitive impairment. Bilingualism promotes cognitive reserve and resilience through the effect of language switching on the cognitive control systems and is sugg...

Introduction: Stroke survivors rate longer-term (>2 years) psychological recovery as their top priority, but data on how frequently psychological consequences occur is lacking. Prevalence of cognitive impairment, depression/anxiety, fatigue, apathy and related psychological outcomes, and whether rates are stable in long-term stroke, is unknown. Pat...

Background There are concerns that the measurement of depression by the Patient Health Questionnaire-9 (PHQ-9), a self-report screening questionnaire, is biased by comorbid stroke sequelae. We, therefore, aimed to investigate these concerns in stroke, benchmarked against a non-stroke comparison sample, using factor analysis. Methods The secondary...

Background: The genetics of late seizure or epilepsy secondary to traumatic brain injury (TBI) or stroke is poorly understood. We undertook a systematic review to test the association of single nucleotide polymorphisms (SNPs) with the risk of posttraumatic epilepsy (PTE) and post-stroke epilepsy (PSE). Methods: We followed methods from our presp...

Background: People who experience an ischaemic stroke are at risk of recurrent vascular events, progression of cerebrovascular disease, and cognitive decline. We assessed whether allopurinol, a xanthine oxidase inhibitor, reduced white matter hyperintensity (WMH) progression and blood pressure (BP) following ischaemic stroke or transient ischaemic...

Background There is increasing interest in the concept of frailty in stroke, including both physical frailty and imaging-evidence of brain frailty. We aimed to 1)establish concurrent validity of a brain frailty measurement against traditional measures of physical and global frailty 2)establish prevalence of brain frailty in stroke survivors with an...

Introduction: Stroke and traumatic brain injury (TBI) accounts for 70% of secondary epilepsy in the adult population. The genetic architecture of epilepsy secondary to TBI or stroke is poorly understood. Objective: We undertook a systematic review to test the association of single nucleotide polymorphisms (SNPs) with the risk of posttraumatic epile...

The seven-item Hospital Anxiety and Depression Scale Depression subscale (HADS-D) and the total score of the 14-item HADS (HADS-T) are both used for major depression screening. Compared to the HADS-D, the HADS-T includes anxiety items and requires more time to complete. We compared the screening accuracy of the HADS-D and HADS-T for major depressio...

Context: Treatment burden is defined as the workload of healthcare for people with long-term conditions and the impact on wellbeing. Stroke survivors often live with considerable treatment burden because of high healthcare workload alongside deficiencies in care provision that can make navigating healthcare systems and managing health more difficul...

Background People living with dementia are more likely to move into care homes. The true prevalence of dementia among care home residents in Scotland is not known. People living with dementia often interact with multiple social and healthcare services, thus routine data may offer a way to enhance understanding. Aim To compare national health and s...

Introduction Moving into a care home is a significant, life-changing experience which occurs to address care needs which cannot be supported elsewhere. UK health policy recommends against moving into a care home from the acute hospital. However, this occurs in practice. Better understanding pathways into care homes could improve support for individ...

Background Frailty and dementia have a bidirectional relationship. However, frailty is rarely reported in clinical trials for dementia and mild cognitive impairment (MCI) which limits assessment of trial applicability. This study aims to use a frailty index (FI) to measure frailty using individual participant data (IPD) from clinical trials for MCI...

Background: Our understanding of the relationship between frailty and stroke, beyond the acute phase of stroke, is limited. We aimed to estimate the prevalence of frailty in stroke survivors using differing methods of assessment and describe relationships with stroke outcomes. Methods: We used data from three international population surveys (Am...

Background: loss of skeletal muscle function, strength and mass is common in older adults, with important socioeconomic impacts. Subclinical hypothyroidism is common with increasing age and has been associated with reduced muscle strength. Yet, no randomized placebo-controlled trial (RCT) has investigated whether treatment of subclinical hypothyro...

Background Pathways into care are poorly understood but important life events for individuals and their families. UK policy is to avoid moving-in to care homes from acute hospital settings. This assumes that moves from secondary care represent a system failure. However, those moving to care homes from community and hospital settings may be fundamen...

Background : The ‘impact’ of a scientific paper is a measure of influence in its field. In recent years, traditional, citation-based measures of impact have been complemented by Altmetrics, which quantify outputs including social media footprint. As authors and research institutions seek to increase their visibility both within and beyond the acade...

Objectives: Research priority setting aims to collate stakeholder opinion to determine the most pressing research questions. Priority setting exercises influence decisions around research funding, development and policy. We compared published dementia research priority setting exercises from international healthcare systems. Methods: Four multid...

Background: There is no consensus on the optimal method for the assessment of frailty. We compared the prognostic utility of two approaches (modified Frailty Index [mFI], Clinical Frailty Scale [CFS]) in older adults (≥65 years) hospitalised with COVID-19 versus age. Methods: We used a test and validation cohort that enrolled participants hospitali...

Background Effective shielding measures and virus mutations have progressively modified the disease between the waves, likewise health care systems have adapted to the outbreak. Our aim was to compare clinical outcomes for older people with COVID-19 in Wave 1 (W1) and 2 (W2). Methods All data, including the Clinical Frailty Scale (CFS), were colle...

Background: Stroke survivors are at an increased risk of developing post-stroke cognitive impairment and post-stroke dementia; those at risk could be identified by brain imaging routinely performed at stroke onset. Aim: This systematic review aimed to identify features which are associated with post-stroke cognitive impairment (including dementia),...

Purpose Current guidance discourages use of antibiotics in COVID-19. However, in older adults, superadded infection may be common and require treatment. Our aim was to investigate the occurrence and outcomes from possible superadded infections, occurring within 2 weeks of hospitalization, in older adults with COVID-19. Methods This was a single ce...

Objective: There are few longitudinal studies of poststroke emotionalism (PSE) and our understanding of the psychological associations of PSE is limited, constraining assessment of existing interventions and the development of new therapies. This study aimed to assess the prevalence and course of PSE over the first year poststroke, and its psychol...

Background: This study aimed to investigate the associations of grip strength with incidence and mortality from dementia and whether these associations differ by sociodemographic and lifestyle factors. Methods: A total of 466 788 participants of the UK Biobank (median age 56.5 years, 54.5% women). The outcome was all-cause dementia incidence and...

Background:Agreeing on priority topics for stroke research can help make best use of limited funding, people and time. Formal priority setting exercises collate stakeholder opinion to reach consensus on the most important research questions. Several stroke research priority setting exercises have been published. Exploring commonalities and differen...

Background & Aims The aim of this study was to determine the effects of krill oil supplementation, on muscle function and size in healthy older adults. Methods Men and women, aged above 65 years, with a BMI less than 35kg/m², who participated in less than 1h per week of structured self-reported exercise, were enrolled in the study (NCT04048096) be...

This systematic review aimed to establish the range and quality of clinical and preclinical evidence supporting the association of individual microRNAs, and the use of microRNA expression in the diagnosis and prognosis of ischaemic or haemorrhagic stroke. Electronic databases were searched from 1993 to October 2021, using key words relevant to conc...

Objectives Cognitive problems following stroke are of key concern to stroke survivors. Discussing risk of dementia at the time of stroke could have implications for follow-up care. However, informing someone who has just had a stroke about risk of dementia could cause distress. This survey explored healthcare professionals’ views on discussing risk...

Objectives: Various informant-based questionnaires are used in clinical practice to screen for pre-stroke cognitive problems. However, there is no guidance on which tool should be preferred. We compared the validity of the two most commonly used informant-based tools. Methods: We recruited consecutively admitted stroke patients. Patients' inform...

Context: To aid prioritisation of funding for stroke research, a Stroke Priority Setting Partnership is being conducted in the UK by The Stroke Association using surveys and workshops with stroke survivors, stroke carers and health professionals. Another valuable source of information about topics that require research is the social media platform...

Background In older age, the benefits of antihypertensive treatment (AHT) become less evident, with greater associated risk. Of particular concern is compromising cerebral blood flow (CBF), especially in those with cognitive impairment. Methods We created a synthesis of the published evidence by searching multiple electronic databases from 1970 to...

Background The reduced renal function has prognostic significance in COVID-19 and it has been linked to mortality in the general population. Reduced renal function is prevalent in older age and thus we set out to better understand its effect on mortality. Methods Patient clinical and demographic data was taken from the COVID-19 in Older People (CO...

Introduction Mechanical thrombectomy (MT) can improve outcomes following ischaemic stroke. Patient selection for MT is predominantly based on physiological and imaging parameters. We assessed whether people living with pre-stroke frailty had differing outcomes following MT. Methods We included consecutive patients undergoing MT at a UK comprehensi...

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Growing evidence suggests a consistent association between atrial fibrillation (AF) and cognitive impairment and dementia that is independent of clinical stroke. This report from the AF-SCREEN International Collaboration summarizes the evidence linking AF to cognitive impairment and dementia. It provides guidance on the investigation and management...

Introduction: A chronic subdural haematoma (cSDH) is a collection of altered blood products between the dura and brain resulting in a slowly evolving neurological deficit. It is increasingly common and, in high income countries, affects an older, multimorbid population. With changing demographics improving the care of this cohort is of increasing...

Background Cognitive and mood problems have been highlighted as priorities in stroke research and guidelines recommend early screening. However, there is limited detail on the preferred approach. We aimed to (1) determine the optimal methods for evaluating psychological problems that pre-date stroke; (2) assess the test accuracy, feasibility and ac...

Purpose: To assess the content, quality, and supporting evidence base of clinical practice guidelines (CPGs) with reference to cognitive assessment in stroke. Materials and methods: We performed a systematic review to identify eligible CPGs pertaining to cognitive assessment in adult stroke survivors. We compared content and strength of recommen...

Background : The ‘impact’ of a scientific paper is a measure of influence in its field. In recent years, traditional, citation-based measures of impact have been complemented by Altmetrics, which quantify outputs including social media footprint. As authors and research institutions seek to increase their visibility both within and beyond the acade...

Background: Previous cohort studies have investigated the relationship between self-reported physical activity (PA) and dementia. Evidence from objective device-measured PA data is lacking. This study aimed to explore the association of device-measured PA with the risk of dementia incidence and common subtypes (Alzheimer's disease [AD] and vascula...

Cognitive impairment is independently associated with kidney disease and increases in prevalence with declining kidney function. At the stage where kidney replacement therapy is required, with dialysis or transplantation, cognitive impairment is up to three times more common, and can present at a younger age. This is not a new phenomenon. The cogni...

Background Despite substantial investment, the dementia drug development pipeline has failed to produce a convincing new pharmacological treatment. This situation is in stark contrast to drug development in oncology, metabolic and cardiovascular medicine, where many novel agents are entering phase III trials or clinical practice. Some of the common...

An understanding of the epidemiology of poststroke dementia (PSD) is necessary to inform research, practice and policy. With increasing primary studies, a contemporary review of PSD could allow for analyses of incidence and prevalence trends. Databases were searched using a prespecified search strategy. Eligible studies described an ischaemic or mi...

Background: Anticholinergic burden (ACB), is defined as the cumulative effect of anticholinergic medication which are widely prescribed to older adults despite increasing ACB being associated with adverse effects such as: falls, dementia and increased mortality. This research explores the views of health care professionals (HCPs) and patients on a...

Background The long-term psychological consequences of stroke and how cognitive problems change over time after the first-year following stroke remain unclear. Particularly, trajectories of domain-specific and domain-general cognitive functions and how cognition interacts with mood, fatigue and quality of life are not well described. Aims To deter...

Objectives This trial aimed to determine the feasibility of recruitment, retention, adherence, and safety of a resistance training (RT) intervention to skeletal muscle failure in both frail and non-frail older adults. Design An 8-week randomised feasibility trial. Setting and participants Older adults, with and without frailty, recruited from bot...

Background Shock index (SI - heart rate/systolic blood pressure) has been studied as a measure of haemodynamic status. We aimed to determine whether SI measures within 72 hours of admission were associated with adverse outcomes in intracerebral haemorrhage (ICH). Methods Patients were drawn from the Virtual International Stroke Trials Archive-Intr...