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Prestroke dementia
R Barba1, M D Castro, M del Mar Morín
1Servicio de Medicina Interna, Hospital de Alcorcón, Madrid, Spain.
Cerebrovascular Diseases (Basel, Switzerland)
|April 18, 2001
Summary
Fifteen percent of stroke patients had dementia before their stroke, experiencing worse outcomes. Pre-stroke dementia is linked to older age, lower education, female sex, prior cerebrovascular disease, and brain atrophy.
Area of Science:
- Neurology
- Geriatrics
- Neuroscience
Background:
- Pre-existing dementia is a significant comorbidity in stroke patients.
- Understanding the prevalence and risk factors for prestroke dementia is crucial for patient management and prognosis.
Purpose of the Study:
- To determine the frequency of dementia preceding a stroke.
- To identify factors associated with prestroke dementia.
- To evaluate the outcome of stroke in patients with prestroke dementia.
Main Methods:
- A cross-sectional study involving 324 consecutive stroke patients.
- Assessment of cognitive and functional status using relative interviews, the Informant Questionnaire on Cognitive Decline in the Elderly, and the Barthel Index.
- Diagnosis of prestroke dementia based on DSM-III-R criteria; comparison of clinical and CT features.
Main Results:
- 15% of stroke patients (49/324) had dementia prior to their stroke.
- Prestroke dementia was associated with older age, lower education, female gender, prior cerebrovascular disease, cerebral and medial temporal lobe atrophy, and leukoaraiosis.
- Independent predictors of prestroke dementia included female sex, low education, previous stroke, and cerebral atrophy.
Conclusions:
- Prestroke dementia affects 15% of stroke patients and is associated with a poorer prognosis.
- The identified associated factors suggest a complex interplay of degenerative and vascular brain pathologies in prestroke dementia.