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Clinical factors associated with dementia in ischaemic stroke
Insights
Ischaemic stroke patients with early dementia often have bilateral brain infarcts and generalized atrophy. Hypertension was a key differentiating risk factor between demented and non-demented stroke groups.
Area of Science:
- Neurology
- Neuroscience
- Gerontology
Background:
- Ischaemic stroke is a leading cause of disability.
- Dementia frequently co-occurs with stroke, impacting patient outcomes.
- Understanding the relationship between stroke characteristics and dementia is crucial.
Purpose of the Study:
- To investigate the clinical, radiological, and psychological differences between ischaemic stroke patients with and without early dementia.
- To identify risk factors and stroke-related features associated with dementia post-stroke.
Main Methods:
- Studied 71 ischaemic stroke patients, divided into early dementia (n=40) and non-demented (n=31) groups.
- Utilized clinical assessment, computed tomography (CT), and Wechsler Adult Intelligence Scale (WAIS) testing.
- Analyzed demographic data, stroke history, neurological deficits, risk factors, and CT findings.
Main Results:
- Demented patients showed a higher prevalence of dominant hemisphere disease, bilateral symptoms, and bilateral infarcts on CT.
- Generalized atrophy combined with infarcts was more common in the demented group.
- Hypertension was the only significant risk factor differing between groups; WAIS showed altered deterioration index in demented patients.
Conclusions:
- Bilateral cerebral infarcts and generalized atrophy are associated with early dementia in ischaemic stroke patients.
- Hypertension appears to be a significant risk factor differentiating stroke patients with and without dementia.
- Further research is warranted to elucidate the complex interplay between stroke, vascular disease, and cognitive decline.
Abstract:
71 patients with an ischaemic stroke were studied. The patients were separated into two groups on the basis of the results of clinical investigation, computed tomography and psychological testing (WAIS). 40 patients showed an early dementia and 31 were without mental impairment. The mean age was 57 years in the demented group and 54 years in the non-demented group. The mean duration of the history of cerebrovascular disease was also not statistically different in both groups. The frequency of strokes was identical since 50% of the patients in both groups had more than one stroke. The history of neurological symptoms together with the neurological deficits seen on admission were distributed evenly. The dominant hemisphere was more often diseased in the demented group. Bilateral symptoms were also more common in the demented stroke patients. The WAIS showed a similar IQ in both groups but the deterioration index was significantly altered in the demented group. Hypertension was the only risk factor which differed between both groups. Cardiac disease, diabetes, viscosity and fibrinogen did not differ in both groups. The CT showed more normal scans in the non-demented group, the distribution of atrophy on its own and infarction in the left or right hemisphere were both inconclusive, whilst patients with bilateral infarcts were more common in the dementia group. Also, generalised atrophy in combination with an infarct was found more often in the demented patients.