Vincent C T Mok1, Bonnie Y K Lam1, Zhaolu Wang2, Wenyan Liu2, Lisa Au2, Eric Y L Leung3, Sirong Chen3, Jie Yang4, Winnie C W Chu5, Alexander Y L Lau2, Anne Y Y Chan2, Lin Shi2, Florence Fan2, Sze H Ma2, Vincent Ip2, Yannie O Y Soo2, Thomas W H Leung2, Timothy C Y Kwok2, Chi L Ho3, Lawrence K S Wong2, Adrian Wong6. 1. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China; Therese Pei Fong Chow Research Centre for Prevention of Dementia, Hong Kong SAR, China. 2. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China. 3. Department of Nuclear Medicine, Hong Kong Sanatorium and Hospital, Hong Kong SAR, China. 4. Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and Ministry of Education of China, Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. 5. Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong SAR, China. 6. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China; Therese Pei Fong Chow Research Centre for Prevention of Dementia, Hong Kong SAR, China. Electronic address: adrianwong@cuhk.edu.hk.
Abstract
INTRODUCTION: Patients surviving stroke without immediate dementia are at high risk of delayed-onset dementia. Mechanisms underlying delayed-onset dementia are complex and may involve vascular and/or neurodegenerative diseases. METHODS: Dementia-free patients with stroke and/or transient ischemic attack (TIA; n = 919) were studied for 3 years prospectively, excluding those who developed dementia 3 to 6 months after stroke and/or TIA. RESULTS: Forty subjects (4.4%) developed dementia during the study period. Imaging markers of severe small vessel disease (SVD), namely presence of ≥3 lacunes and confluent white matter changes; history of hypertension and diabetes mellitus independently predicted delayed-onset dementia after adjustment for age, gender, and education. Only 6 of 31 (19.4%) subjects with delayed cognitive decline harbored Alzheimer's disease-like Pittsburg compound B (PiB) retention. Most PiB cases (16/25, 64%) had evidence of severe SVD. DISCUSSION: Severe SVD contributes importantly to delayed-onset dementia after stroke and/or TIA. Future clinical trials aiming to prevent delayed-onset dementia after stroke and/or TIA should target this high-risk group.
INTRODUCTION:Patients surviving stroke without immediate dementia are at high risk of delayed-onset dementia. Mechanisms underlying delayed-onset dementia are complex and may involve vascular and/or neurodegenerative diseases. METHODS:Dementia-freepatients with stroke and/or transient ischemic attack (TIA; n = 919) were studied for 3 years prospectively, excluding those who developed dementia 3 to 6 months after stroke and/or TIA. RESULTS: Forty subjects (4.4%) developed dementia during the study period. Imaging markers of severe small vessel disease (SVD), namely presence of ≥3 lacunes and confluent white matter changes; history of hypertension and diabetes mellitus independently predicted delayed-onset dementia after adjustment for age, gender, and education. Only 6 of 31 (19.4%) subjects with delayed cognitive decline harbored Alzheimer's disease-like Pittsburg compound B (PiB) retention. Most PiB cases (16/25, 64%) had evidence of severe SVD. DISCUSSION: Severe SVD contributes importantly to delayed-onset dementia after stroke and/or TIA. Future clinical trials aiming to prevent delayed-onset dementia after stroke and/or TIA should target this high-risk group.
Authors: Terence J Quinn; Edo Richard; Yvonne Teuschl; Thomas Gattringer; Melanie Hafdi; John T O'Brien; Niamh Merriman; Celine Gillebert; Hanne Huyglier; Ana Verdelho; Reinhold Schmidt; Emma Ghaziani; Hysse Forchammer; Sarah T Pendlebury; Rose Bruffaerts; Milija Mijajlovic; Bogna A Drozdowska; Emily Ball; Hugh S Markus Journal: Eur Stroke J Date: 2021-10-08
Authors: Natalia S Rost; James F Meschia; Rebecca Gottesman; Lisa Wruck; Karl Helmer; Steven M Greenberg Journal: Stroke Date: 2021-05-27 Impact factor: 10.170
Authors: Perminder S Sachdev; Jessica W Lo; John D Crawford; Lisa Mellon; Anne Hickey; David Williams; Régis Bordet; Anne-Marie Mendyk; Patrick Gelé; Dominique Deplanque; Hee-Joon Bae; Jae-Sung Lim; Amy Brodtmann; Emilio Werden; Toby Cumming; Sebastian Köhler; Frans R J Verhey; Yan-Hong Dong; Hui Hui Tan; Christopher Chen; Xu Xin; Raj N Kalaria; Louise M Allan; Rufus O Akinyemi; Adesola Ogunniyi; Aleksandra Klimkowicz-Mrowiec; Martin Dichgans; Frank A Wollenweber; Vera Zietemann; Michael Hoffmann; David W Desmond; Thomas Linden; Christian Blomstrand; Björn Fagerberg; Ingmar Skoog; Olivier Godefroy; Mélanie Barbay; Martine Roussel; Byung-Chul Lee; Kyung-Ho Yu; Joanna Wardlaw; Stephen J Makin; Fergus N Doubal; Francesca M Chappell; Velandai K Srikanth; Amanda G Thrift; Geoffrey A Donnan; Nagaendran Kandiah; Russell J Chander; Xuling Lin; Charlotte Cordonnier; Solene Moulin; Costanza Rossi; Behnam Sabayan; David J Stott; J Wouter Jukema; Susanna Melkas; Hanna Jokinen; Timo Erkinjuntti; Vincent C T Mok; Adrian Wong; Bonnie Y K Lam; Didier Leys; Hilde Hénon; Stéphanie Bombois; Darren M Lipnicki; Nicole A Kochan Journal: Alzheimers Dement (Amst) Date: 2016-11-18
Authors: Nick A Weaver; Lei Zhao; J Matthijs Biesbroek; Hugo J Kuijf; Hugo P Aben; Hee-Joon Bae; Miguel Á A Caballero; Francesca M Chappell; Christopher P L H Chen; Martin Dichgans; Marco Duering; Marios K Georgakis; Ruben S van der Giessen; Bibek Gyanwali; Olivia K L Hamilton; Saima Hilal; Elise M Vom Hofe; Paul L M de Kort; Peter J Koudstaal; Bonnie Y K Lam; Jae-Sung Lim; Stephen D J Makin; Vincent C T Mok; Lin Shi; Maria C Valdés Hernández; Narayanaswamy Venketasubramanian; Joanna M Wardlaw; Frank A Wollenweber; Adrian Wong; Xu Xin; Geert Jan Biessels Journal: Alzheimers Dement (Amst) Date: 2019-04-12
Authors: Russell J Chander; Bonnie Y K Lam; Xuling Lin; Aloysius Y T Ng; Adrian P L Wong; Vincent C T Mok; Nagaendran Kandiah Journal: Sci Rep Date: 2017-09-29 Impact factor: 4.379
Authors: Anuska V Andjelkovic; Svetlana M Stamatovic; Chelsea M Phillips; Gabriela Martinez-Revollar; Richard F Keep Journal: Fluids Barriers CNS Date: 2020-07-16