Related Experiment Videos
Dementia after stroke: baseline frequency, risks, and clinical features in a hospitalized cohort
T K Tatemichi1, D W Desmond, R Mayeux
1Department of Neurology, Columbia University, College of Physicians and Surgeons, New York, NY.
Insights
Acute ischemic stroke significantly increases dementia risk. This study found dementia in 26.3% of stroke patients versus 3.2% in controls, highlighting stroke as a major dementia risk factor.
Area of Science:
- Neurology
- Geriatrics
- Epidemiology
Background:
- Dementia is a growing public health concern, particularly in aging populations.
- The relationship between acute ischemic stroke and subsequent dementia risk requires further elucidation.
Purpose of the Study:
- To determine the frequency of dementia in patients hospitalized with acute ischemic stroke.
- To assess the risk of dementia associated with stroke compared to a stroke-free control group.
- To identify independent correlates of dementia in stroke survivors.
Main Methods:
- A cohort of 251 patients (≥60 years) hospitalized with acute ischemic stroke were assessed for dementia 3 months post-stroke using modified DSM-III-R criteria.
- A control group of 249 age-matched, stroke-free community subjects were also evaluated.
- Logistic regression analysis was employed to calculate the odds ratio (OR) for dementia in stroke patients versus controls.
Main Results:
- Dementia was diagnosed in 26.3% of stroke patients, compared to 3.2% in the control group.
- Ischemic stroke was associated with a significantly increased risk of dementia (OR = 9.4, p < 0.001).
- Advancing age, lower education levels, and race (non-white) were identified as independent correlates of dementia.
Conclusions:
- Acute ischemic stroke is a significant risk factor for developing dementia.
- Age, education, and race independently contribute to dementia risk in the context of stroke.
- These findings underscore the importance of stroke prevention and management for reducing dementia incidence.
Abstract:
We determined the frequency of dementia in a cohort of 251 patients aged greater than or equal to 60 years hospitalized with acute ischemic stroke, based on examinations performed 3 months after stroke onset. Using modified DSM-III-R criteria, we found dementia in 66 patients (26.3%). Diagnostic agreement among raters was excellent (kappa = 0.96). In a control sample of 249 stroke-free subjects recruited from the community and matched by age, we found dementia in eight subjects (3.2%). Using a logistic regression model to estimate the risk of dementia associated with stroke in the combined samples, the odds ratio (OR) for stroke patients compared with control subjects was 9.4 (p less than 0.001). Advancing age and fewer years of education were significant, independent correlates of dementia, with a trend evident for race (non-white versus white). Confining the analysis to subjects residing in the Washington Heights-Inwood community of northern Manhattan, the OR was 10.3 (p less than 0.001) with significant age and race effects. We conclude that ischemic stroke significantly increases the risk of dementia, with independent contributions by age, education, and race.