New Onset Poststroke Dementia at one Year in Africans

Area of Science:

• Neurology
• Public Health
• Epidemiology

Background:

• Limited data exists on new onset poststroke dementia (NPSD) in sub-Saharan Africa (SSA).
• This study investigated the incidence, risk factors, and outcomes of NPSD in Nigerian stroke survivors.
• Focus on a 1-year follow-up period for a first-ever stroke cohort.

Purpose of the Study:

• To estimate the incidence and cumulative incidence of NPSD at 1 year post-stroke in Nigeria.
• To identify risk factors associated with NPSD.
• To evaluate the outcomes of NPSD, including functional decline, depression, caregiver burden, and quality of life.

Main Methods:

• A prospective observational study was conducted with 144 stroke survivors initially free of dementia.
• Cognitive function and activities of daily life (ADL) were assessed at baseline, 3 months, and 12 months.
• NPSD was diagnosed using National Institute of Neurological Disorders and Stroke and the Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS-AIREN) criteria. Outcomes measured included modified Rankin Scale (mRS), CES-D 10, HRQOLISP-26, and Caregiver Strain Index (CSI).

Main Results:

• The 1-year cumulative incidence of NPSD was 4.52% (95% CI = 3.20, 6.39).
• Diabetes mellitus was identified as a significant risk factor for NPSD (Hazard Ratio = 2.10, 95% CI = 1.02, 4.35).
• NPSD at 3 months correlated with motor decline, depression, increased caregiver burden, and poorer quality of life at 1 year.

Conclusions:

• Approximately 4.5% of Nigerian stroke survivors develop NPSD within one year.
• Diabetes is a preventable risk factor and a potential primary prevention target for NPSD and its consequences in SSA.
• Early identification and management of NPSD are critical for improving patient outcomes and reducing the burden on caregivers.