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Updated: Dec 21, 2025

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Incidence and risk factors of vascular dementia in Thai stroke patients
Pornpatr A Dharmasaroja1, Chanin Limwongse2, Thammanard Charernboon3
1Department of Medicine, Faculty of Medicine, Thammasat University, Klong 1, Klong Luang, Pathumthani 12120, Thailand; Faculty of Medicine, Chulabhorn International College of Medicine, Thammasat University, Klong 1, Klong Luang, Pathumthani 12120, Thailand.
Insights
Vascular dementia (VAD) affects 27% of stroke survivors. Key risk factors include older age, lower education, prior stroke history, and white matter lesions, highlighting the need for targeted VAD prevention strategies.
Area of Science:
- Neurology
- Geriatrics
- Public Health
Background:
- Vascular cognitive impairment (VCI) significantly impacts stroke survivors' independence.
- VCI encompasses conditions like vascular mild cognitive impairment (VMCI) and vascular dementia (VAD).
Purpose of the Study:
- To determine the incidence of vascular dementia (VAD) in Thai stroke patients.
- To identify risk factors associated with VAD development in this population.
Main Methods:
- Prospective study of adult ischemic stroke patients.
- Cognitive function assessed using the Montreal Cognitive Assessment (MOCA)-Thai version (cutoff 24/25) 3-6 months post-stroke.
- Comparison of demographic, Apolipoprotein E (ApoE) status, and stroke characteristics between VAD and non-VAD groups.
Main Results:
- VAD diagnosed in 27% (49/180) of patients; 50% had VMCI.
- Older age (OR 4.99), lower education (OR 10.31), prior stroke (OR 4.96), and moderate-to-severe white matter lesions (OR 5.56) were significant risk factors for VAD.
- ApoE 4 allele presence did not correlate with increased VAD risk.
Conclusions:
- Vascular dementia (VAD) is prevalent in 27% of Thai stroke survivors.
- Older age, limited education, stroke history, and cerebral white matter lesions are key risk factors for VAD.
- Further research may explore targeted interventions for VAD prevention in stroke populations.
Background:
Besides disability in stroke survivors, vascular cognitive impairment (VCI) can prevent these patients from living independently. The purpose of this study is to look for the incidence and risk factors of vascular dementia in Thai patients with stroke.
Methods:
Adults patients with ischemic stroke were prospectively included. Cognitive assessment was performed at 3-6 months after stroke onset. Montreal Cognitive Assessment (MOCA)- Thai version was used to evaluate cognitive function, with the cutoff point of 24/25 of MOCA to define cognitive impairment/normal cognition. Vascular mild cognitive impairment (VMCI) and vascular dementia (VAD) were diagnosed in those with cognitive impairment. Epidemiologic data, Apolipoprotein E (ApoE) status, and stroke characteristics were compared between patients with and without VAD.
Results:
There were 180 patients with the mean age of 65 years. Median time after stroke onset to have cognitive assessment was 6 months. Ninety patients (50%) had VMCI. VAD was diagnosed in 49 patients (27%). Mean Thai version of mental state examination (TMSE) and MOCA scores in patients with VAD were 20 and 12, respectively. Multivariate analysis showed that older age (OR 4.994, 95%CI 1.602-15.565, p-value = 0.006), lower education (OR 10.306, 95%CI 3.162-33.586, p-value < 0.001), history of stroke (OR 4.959, 95%CI 1.036-23.741, p-value = 0.045) and moderate to severe cerebral white matter lesions (OR 5.555, 95%CI 1.710-18.041, p-value = 0.004) were associated with VAD. ApoE 4 allele was found in 25% of the patients, but the presence did not show any association with the increased risk of VAD.
Conclusions:
VAD occurred in 27% of the stroke patients. Older age, low education level, history of stroke, and the presence of moderate to severe white matter lesions were associated with the increased risk of VAD.
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