BACKGROUND AND PURPOSE: There are few data on long-term cognitive outcomes after first-ever stroke. We aimed to study long-term cognitive transitions, rates of cognitive change, and factors associated with incident dementia and cognitive impairment-no dementia (CIND) 2 years after first-ever stroke. METHODS: A population-based cohort of incident first-ever stroke cases (n=99; mean age, 69.9 years) and an age- and sex-matched comparison group (nonstrokes, n=99) were followed up for 2 years by 3 serial examinations. Rates of cognitive change were compared by repeated-measures analyses. Factors associated with incident dementia and CIND at 2 years were determined by multinomial logistic regression. RESULTS: Significant stroke x time interactions were present for all cognitive domains, with stroke cases showing a greater rate of decline compared with nonstrokes. Stroke recurrence during follow-up was responsible for significantly greater global decline. Strokes with recurrence (P=0.02), age (P=0.004), and baseline cognitive impairment (P<0.001) were independently associated with incident dementia at 2 years. Strokes without recurrence (P=0.008), age (P=0.001), and baseline cognitive impairment (P<0.001) were independently associated with CIND at 2 years. CONCLUSIONS: Recurrent stroke contributes importantly to global cognitive decline after a first-ever stroke. Secondary stroke prevention will be important in ameliorating dementia related to stroke. Mechanisms underlying the progression of early cognitive impairment to dementia in stroke patients need further investigation.
BACKGROUND AND PURPOSE: There are few data on long-term cognitive outcomes after first-ever stroke. We aimed to study long-term cognitive transitions, rates of cognitive change, and factors associated with incident dementia and cognitive impairment-no dementia (CIND) 2 years after first-ever stroke. METHODS: A population-based cohort of incident first-ever stroke cases (n=99; mean age, 69.9 years) and an age- and sex-matched comparison group (nonstrokes, n=99) were followed up for 2 years by 3 serial examinations. Rates of cognitive change were compared by repeated-measures analyses. Factors associated with incident dementia and CIND at 2 years were determined by multinomial logistic regression. RESULTS: Significant stroke x time interactions were present for all cognitive domains, with stroke cases showing a greater rate of decline compared with nonstrokes. Stroke recurrence during follow-up was responsible for significantly greater global decline. Strokes with recurrence (P=0.02), age (P=0.004), and baseline cognitive impairment (P<0.001) were independently associated with incident dementia at 2 years. Strokes without recurrence (P=0.008), age (P=0.001), and baseline cognitive impairment (P<0.001) were independently associated with CIND at 2 years. CONCLUSIONS: Recurrent stroke contributes importantly to global cognitive decline after a first-ever stroke. Secondary stroke prevention will be important in ameliorating dementia related to stroke. Mechanisms underlying the progression of early cognitive impairment to dementia in strokepatients need further investigation.
Authors: Deborah A Levine; Andrzej T Galecki; Kenneth M Langa; Frederick W Unverzagt; Mohammed U Kabeto; Bruno Giordani; Virginia G Wadley Journal: JAMA Date: 2015-07-07 Impact factor: 56.272
Authors: Hyun Ah Kim; Alyson A Miller; Grant R Drummond; Amanda G Thrift; Thiruma V Arumugam; Thanh G Phan; Velandai K Srikanth; Christopher G Sobey Journal: Naunyn Schmiedebergs Arch Pharmacol Date: 2012-08-08 Impact factor: 3.000
Authors: Elżbieta Kuźma; Ilianna Lourida; Sarah F Moore; Deborah A Levine; Obioha C Ukoumunne; David J Llewellyn Journal: Alzheimers Dement Date: 2018-08-31 Impact factor: 21.566
Authors: Philip B Gorelick; Angelo Scuteri; Sandra E Black; Charles Decarli; Steven M Greenberg; Costantino Iadecola; Lenore J Launer; Stephane Laurent; Oscar L Lopez; David Nyenhuis; Ronald C Petersen; Julie A Schneider; Christophe Tzourio; Donna K Arnett; David A Bennett; Helena C Chui; Randall T Higashida; Ruth Lindquist; Peter M Nilsson; Gustavo C Roman; Frank W Sellke; Sudha Seshadri Journal: Stroke Date: 2011-07-21 Impact factor: 7.914
Authors: Arun S Karlamangla; Dana Miller-Martinez; Carol S Aneshensel; Teresa E Seeman; Richard G Wight; Joshua Chodosh Journal: Am J Epidemiol Date: 2009-07-15 Impact factor: 4.897
Authors: Deborah A Levine; Mary N Haan; Kenneth M Langa; Lewis B Morgenstern; John Neuhaus; Anne Lee; Lynda D Lisabeth Journal: J Stroke Cerebrovasc Dis Date: 2012-06-27 Impact factor: 2.136