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Mortality in patients with dementia after ischemic stroke
David W Desmond1, Joan T Moroney, Mary Sano
1Department of Neurology, SUNY Downstate Medical Center, Brooklyn, NY 11203, USA. dwdesmond@usa.net
Neurology
|August 28, 2002
Summary
Dementia significantly increases mortality risk in ischemic stroke survivors. Patients with dementia face a 2.4 times higher risk of death, highlighting dementia as a critical factor in stroke patient outcomes.
Area of Science:
- Neurology
- Gerontology
- Public Health
Background:
- Dementia is often viewed as a consequence of neurological diseases.
- However, dementia can also be a risk factor for adverse health outcomes.
- This study explores dementia's role as a predictor of long-term survival post-ischemic stroke.
Purpose of the Study:
- To investigate dementia as a predictor of long-term survival in patients following an ischemic stroke.
- To quantify the impact of dementia on mortality risk in this patient population.
Main Methods:
- 453 ischemic stroke patients underwent assessments 3 months post-stroke.
- Dementia was diagnosed in 119 patients (26.3%) using modified DSM-III-R criteria.
- Long-term survival was tracked for up to 10 years.
Main Results:
- Mortality rates were higher in patients with dementia (15.90 deaths/100 person-years) compared to those without (5.37 deaths/100 person-years).
- Dementia was associated with a 2.4-fold increased relative risk of death, even after adjusting for stroke severity, comorbidities, and demographic factors.
- The risk of death increased with dementia severity but did not vary by subtype.
Conclusions:
- Dementia is a significant, independent risk factor for decreased survival after ischemic stroke.
- Potential reasons for elevated mortality include increased cerebrovascular disease burden, undertreatment of stroke prophylaxis, or patient noncompliance.