Peter Hobson1, Jolyon Meara. 1. Academic Unit, Cardiff University, Glan Clwyd Hospital, Conwy and Denbighshire National Health Service Trust, Rhyl, United Kingdom. peterhobson@hotmail.com
Abstract
OBJECTIVE: We sought to determine the frequency and incidence of cognitive impairments not dementia, dementia, and mortality in first-ever stroke survivors and control subjects. METHODS: We conducted a longitudinal follow-up of a cohort of first-ever stroke survivors (n=98) and age-/sex-matched control subjects (n=92). RESULTS: At baseline, 37 stroke survivors and 4 control subjects fulfilled Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for dementia. From baseline to follow-up, 6 new patients in the nondemented stroke cohort and 4 patients in the stroke-free cohort developed dementia, giving an incidence of 3.97 (95% confidence interval [CI] 1.46-8.65) and 1.78 (95% CI 0.49-4.57), respectively. The stroke cohort had a more than 2-fold increased risk for developing dementia (relative risk=2.14, 95% CI 0.64-7.13). The cumulative rate of mortality in the stroke cohort was 11.03 per 100 person-years (95% CI 7.7-15.3) and in the stroke-free cohort it was 3.47 per 100 person-years (95% CI 1.13-8.1). The risk for mortality after controlling for dementia cases at baseline was more than 2.5 times that of the stroke-free cohort. CONCLUSIONS: A first-ever stroke increases the risk of developing dementia, Mortality in our stroke cohort was still higher than that observed in the stroke-free cohort. Improved survival poststroke may be contributing to an increased risk for cognitive impairment or dementia in this population. Copyright (c) 2010 National Stroke Association. Published by Elsevier Inc. All rights reserved.
OBJECTIVE: We sought to determine the frequency and incidence of cognitive impairments not dementia, dementia, and mortality in first-ever stroke survivors and control subjects. METHODS: We conducted a longitudinal follow-up of a cohort of first-ever stroke survivors (n=98) and age-/sex-matched control subjects (n=92). RESULTS: At baseline, 37 stroke survivors and 4 control subjects fulfilled Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for dementia. From baseline to follow-up, 6 new patients in the nondemented stroke cohort and 4 patients in the stroke-free cohort developed dementia, giving an incidence of 3.97 (95% confidence interval [CI] 1.46-8.65) and 1.78 (95% CI 0.49-4.57), respectively. The stroke cohort had a more than 2-fold increased risk for developing dementia (relative risk=2.14, 95% CI 0.64-7.13). The cumulative rate of mortality in the stroke cohort was 11.03 per 100 person-years (95% CI 7.7-15.3) and in the stroke-free cohort it was 3.47 per 100 person-years (95% CI 1.13-8.1). The risk for mortality after controlling for dementia cases at baseline was more than 2.5 times that of the stroke-free cohort. CONCLUSIONS: A first-ever stroke increases the risk of developing dementia, Mortality in our stroke cohort was still higher than that observed in the stroke-free cohort. Improved survival poststroke may be contributing to an increased risk for cognitive impairment or dementia in this population. Copyright (c) 2010 National Stroke Association. Published by Elsevier Inc. All rights reserved.
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