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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
PubMed
Summary
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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.

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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.