1. Progressive dementia after first-ever stroke: a community-based follow-up study.
- Author
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Srikanth VK, Anderson JF, Donnan GA, Saling MM, Didus E, Alpitsis R, Dewey HM, Macdonell RA, and Thrift AG
- Subjects
- Aged, Aged, 80 and over, Bias, Case-Control Studies, Cerebral Infarction classification, Cerebral Infarction epidemiology, Cognition Disorders epidemiology, Cognition Disorders etiology, Cohort Studies, Comorbidity, Dementia etiology, Disease Progression, Female, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Neuropsychological Tests, Patient Selection, Risk Factors, Single-Blind Method, United States epidemiology, Cerebral Infarction complications, Dementia epidemiology
- Abstract
Objectives: To examine the risk and determinants of a progressive dementia syndrome and cognitive impairment not dementia (CIND) in community-based nonaphasic first-ever stroke cases 1 year after stroke, relative to a matched community-based stroke-free group., Methods: Matched cohort design, with cognitive tests given on two occasions 9 months apart to 99 mild-to-moderate first-ever stroke patients and 99 age- and sex-matched people without stroke. At follow-up, progressive dementia or CIND were diagnosed, with judges blinded to stroke/nonstroke status., Results: Progressive dementia was diagnosed in 12.5% of stroke patients and 15.4% of those without strokes (RR 1.1, 95% CI 0.5 to 2.2, p = 0.85). CIND was diagnosed in 37.5% of stroke patients and 17.6% of participants without strokes (RR 2.1, 95% CI 1.2 to 3.4, p = 0.003). In multivariable regression, age (p = 0.04) and baseline cognition (p < 0.001) were independently associated with dementia whereas stroke (p = 0.002), age (p = 0.05), baseline cognition (p = 0.001), and baseline mood (p = 0.03) were independently associated with CIND at follow-up., Conclusions: In this community-based nonaphasic sample, mild-to moderate first-ever stroke was not associated with the presence of progressive dementia 1 year later, but was clearly associated with a greater risk of cognitive impairment not dementia (CIND). Baseline mood impairment remained independently associated with CIND at 1 year after taking into account stroke, age, and baseline cognitive ability.
- Published
- 2004
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