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Related Concept Videos

Dementia01:30

Dementia

511
Dementia is a collective term for cognitive disorders primarily affecting memory, thinking, and reasoning. It is not a specific disease but a syndrome, with Alzheimer's disease being the most common cause, accounting for approximately 60-80% of cases. Other types include vascular dementia, Lewy body dementia, and frontotemporal dementia. Dementia affects millions worldwide, particularly older adults, though it is not a normal part of aging.
The progression of dementia is generally gradual....
511

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Development of a Prognostic Model for Poststroke Dementia Using Multiple International Cohorts: A STROKOG

Jessica W Lo1, John D Crawford1, David W Desmond2

  • 1Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia.

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Summary

A new dementia risk model predicts 5-year risk in stroke survivors using common clinical data. This tool aids in identifying high-risk individuals for better cognitive monitoring and outcomes.

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Area of Science:

  • Neurology
  • Epidemiology
  • Biostatistics

Background:

  • General dementia risk models perform poorly in stroke survivors.
  • Existing stroke-specific models are limited in scope and accessibility.
  • Need for a clinically practical dementia risk prediction tool for post-stroke patients.

Purpose of the Study:

  • To develop a clinically practical model for predicting 5-year dementia risk after stroke.
  • Utilize commonly available variables and individual participant data.
  • Leverage data from the Stroke and Cognition Consortium (STROKOG).

Main Methods:

  • Pooled data from 12 international studies.
  • Employed Fine-Gray subdistribution hazard models accounting for competing risks (death).
  • Utilized backward stepwise elimination for predictor selection and internal-external cross-validation (IECV) for generalizability assessment.

Main Results:

  • Developed a model including age, sex, education, prior stroke, diabetes, stroke severity, and interactions.
  • The model demonstrated strong discrimination (C-index: 0.81) and excellent calibration in the development dataset.
  • IECV showed acceptable discrimination across studies (pooled C-index: 0.70), performing better in recent and European cohorts.

Conclusions:

  • A validated 5-year dementia risk model for stroke survivors was developed using routine clinical variables.
  • The model shows good generalizability, particularly in recent and European cohorts.
  • This tool can facilitate targeted cognitive monitoring, improve clinical decision-making, and enhance long-term patient outcomes.