Progressive dementia after first-ever stroke: a community-based follow-up study.

Area of Science:

• Neuroscience
• Gerontology
• Public Health

Background:

• Stroke is a leading cause of long-term disability.
• Cognitive impairment, including dementia and CIND, is a common sequela of stroke.
• Understanding post-stroke cognitive changes is crucial for patient care and public health.

Purpose of the Study:

• To investigate the incidence and determinants of progressive dementia and cognitive impairment not dementia (CIND) one year after a first-ever stroke.
• To compare cognitive outcomes in stroke survivors with a matched stroke-free cohort.

Main Methods:

• A matched cohort study design was employed.
• 99 mild-to-moderate first-ever stroke patients and 99 matched controls underwent cognitive testing at baseline and 9 months.
• Diagnoses of progressive dementia and CIND were made by blinded judges at 1-year follow-up.

Main Results:

• Progressive dementia incidence was similar between stroke patients (12.5%) and controls (15.4%).
• Cognitive impairment not dementia (CIND) was significantly higher in stroke patients (37.5%) compared to controls (17.6%).
• Stroke, age, baseline cognition, and baseline mood independently predicted CIND at follow-up.

Conclusions:

• Mild-to-moderate first-ever stroke is not associated with an increased risk of progressive dementia one year later.
• Stroke is associated with a significantly higher risk of developing cognitive impairment not dementia (CIND).
• Baseline mood impairment is an independent predictor of CIND, even after accounting for stroke, age, and cognitive status.