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Study on frequency and predictors of dementia after ischemic stroke

The Chongqing Stroke Study

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Abstract.

Objective:

We studied a large hospitalized cohort of patients aged 55 years and over with acute ischemic stroke to identify the frequency and predictors of poststroke dementia.

Methods:

A total of 434 consecutive patients with ischemic stroke were enrolled in this study. During admission, the demographic data, vascular risk factors, stroke features, and neurological status information were collected. All subjects were examined by a battery of neuropsychological tests during admission and 3 months after stroke. Logistic regression analysis was used to find the predictors of poststroke dementia.

Results:

(1) The frequency of poststroke dementia was 27.2%, that of stroke-related dementia was 21.6%, and that of dementia after first-ever stroke was 22.7% 3 months after stroke. (2) Univariate analysis indicated that older age, low educational level (≤ 6 years), everyday drinking, diabetes mellitus, atrial fibrillation, prior stroke, left carotid territory infarction, embolism, multiple stroke lesions, dysphasia, and gait impairment were more frequent in the patients with poststroke dementia. (3) Multivariate analyses demonstrated that age (OR 1.179, 95%CI 1.130–1.230), low educational level (OR 1.806, 95 %CI 1.024–3.186), everyday drinking (OR 3.447, 95 %CI 1.591–7.468), prior stroke (OR 2.531, 95 %CI 1.419–4.512), atrial fibrillation (OR 3.475, 95%CI 1.712–7.057), dysphasia (OR 5.873, 95 %CI 2.620–13.163), and left carotid territory infarction (OR 1.975, 95%CI 1.152–3.388) were associated with poststroke dementia.

Conclusions:

The frequency of dementia is about one-forth of patients with ischemic stroke 3 months after stroke. Independent predictors of poststroke dementia include age, low educational level, everyday drinking, prior stroke, dysphasia, atrial fibrillation, and left carotid territory infarction.

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Abbreviations

AD:

Alzheimer’s disease

ADL:

Activity of Daily Living

CI:

Confidence Interval

CMMS:

Chinese version of the Mini-Mental State Examination

CT:

Computed Tomography

DSM-IV:

Diagnostic and Statistical Manual of Mental Disorders, 4th edition

FOM:

Fuld Object Memory Evaluation

IADL:

Instrumental Activity of Daily Living

IQCODE:

Informant Questionnaire on Cognitive Decline in the Elderly

MRI:

Magnetic Resonance Imaging

OR:

Odds Ratio

POD:

Pfeiffer Outpatient Disability Questionnaire

RVR:

Rapid Verbal Retrieve

SD:

Standard Error

TIA:

Transient Ischemic Attack

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Correspondence to David H. D. Zhou MD.

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Zhou, D.H.D., Wang, J.Y.J., Li, J. et al. Study on frequency and predictors of dementia after ischemic stroke. J Neurol 251, 421–427 (2004). https://doi.org/10.1007/s00415-004-0337-z

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  • DOI: https://doi.org/10.1007/s00415-004-0337-z

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