Dementia After First Stroke

Censori, B.; Manara, Ornella; Agostinis, Cristina; Camerlingo, M.; Casto, L.; Galavotti, Bruna; Partziguian, T.; Servalli, Maria Cristina; Cesana, Bruno Mario; Belloni, G; Mamoli, A

doi:10.1161/01.str.27.7.1205

Cited by 183 publications

(216 citation statements)

References 43 publications

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“…For some evidences, an atrial fibrillation was relevant to cognitive impairment and hippocampal atrophy with no symptomatic stroke or silent infarction. 34,35 The previous studies 26,30,31,[36][37][38][39] and the results of our study have shown that atrial fibrillation was associated with an increased risk of poststroke dementia. Moreover, the result of this study found that stroke patients with atrial fibrillation risk of dementia were 1.68 times compared with stroke patients without atrial fibrillation statistically significant.…”

Section: Discussionsupporting

confidence: 53%

“…48 Diabetes mellitus has been associated with various adverse health effects, and it was found that patients with diabetes mellitus were more likely than normal patients to have low MMSE 49 reduced cerebral blood flow associated with impaired cerebral auto regulation, increased blood viscosity, and greater prevalence of underlying intracranial large-or small-artery disease. 50 Similarly, the reported association between stroke patients with and without diabetes mellitus of other studies 20,21,26,30,31,39,46 found that diabetes mellitus associated with an increased prevalence of post-stroke dementia. The present study showed that stroke patients with diabetes mellitus risk of dementia were 1.25 times compared with stroke patients without diabetes mellitus statistically significant.…”

Section: Reviewmentioning

confidence: 89%

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Risk factors associated with post-stroke dementia: a systematic review and meta-analysis

et al. 2017

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This study aimed to evaluate the risk factors for prognostic of post-stroke dementia (PSD). A systematic review included case-control and/or cohort studies, we searched both published and unpublished literatures between 2000 to July 31, 2016. Two authors independently screened and selected research articles. If another one disagreed, the third author would be just along with his/her professionally. Moreover, Critical appraisal was measured by the quality (GRADE). Data collection was in the data extraction form. The Rev-Man 5.3 was used to estimate pooled data. The fixed-effect model will be used when the heterogeneity I² <50%, whereas the random-effects model will be used when the heterogeneity I²>50%. Result eight publications were pooled for measuring an association between risk factors and PSD by meta-analysis. There were 6 strongly PSD risk factors. The pooled relative ratio (RR) of atrial fibrillation was 1.68, previous stroke 1.59, myocardial infarction 1.40, hypertension 1.36, diabetes mellitus 1.25 and previous transient ischemic attack 1.25 respectively. Un-pooled data from 13 publications reported that the risk factors for dementia in stroke patients were i) demographic factors, ii) vascular risk factors, iii) stroke factors, iv) stroke complications, and v) abnormalities on brain imaging. Strongly risk factors associated with increasing PSD risk were atrial fibrillation, previous stroke, myocardial infarction, hypertension, diabetes mellitus, and previous transient ischemic attack. Further studies, strongly risk factors need to investigate and develop the risk score for the prediction of dementia in stroke patients.

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Section: Discussionsupporting

confidence: 53%

Section: Reviewmentioning

confidence: 89%

Risk factors associated with post-stroke dementia: a systematic review and meta-analysis

et al. 2017

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“…We censored TICS-m scores occurring after incident strokes, because stroke increases the risk for cognitive impairment and dementia. 20,50 Anemia and certain medications can cause cognitive dysfunction, and both are seen commonly in CKD, so we carried out secondary analyses adjusting for baseline hematocrit and psychoactive medication use. Analyses were conducted with SAS 9.1.3 software (Cary, NC).…”

Section: Discussionmentioning

confidence: 99%

CKD Associates with Cognitive Decline

Khatri¹,

Nickolas²,

Moon

et al. 2009

Journal of the American Society of Nephrology

128

116

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Cognitive impairment and chronic kidney disease (CKD) will become increasingly prevalent in the aging US population. Although evidence exists that CKD is a risk factor for cognitive decline, longitudinal studies are limited and largely have excluded ethnically diverse populations. The Northern Manhattan Study includes a population-based, prospective, stroke-free cohort. We assessed global cognitive function annually using the modified Telephone Interview for Cognitive Status (TICS-m) and estimated kidney function using CockcroftGault creatinine clearance (CCl), Modification of Diet in Renal Disease estimated GFR (eGFR), and serum creatinine (sCr). We examined the association between CKD and change in TICS-m scores over time, adjusting for sociodemographic and vascular risk factors. Of 2172 subjects (mean age 71.5 yr, mean follow-up 2.9 yr), 59% were Hispanic, 20% were black, and 63% were women. Participants with a CCl Ͻ60 ml/min and those with a CCl between 60 and 90 ml/min performed significantly worse on the TICS-m over time than those with a CCl Ͼ90 ml/min, adjusting for potential confounders. Our results were similar when we used eGFR or sCr to estimate kidney function. In conclusion, decreased kidney function associates with greater cognitive decline, even in those with mild CKD. Kidney disease may represent a novel mechanism leading to cognitive impairment and a target for early intervention.

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“…[138][139][140][141]143 Prevalence rates vary between 13.6% 140 and 31.8% 142 at 3 months. Kokmen et al (1996) 138 have shown that the cumulative incidence of dementia in a stroke cohort increased from 7% at year 1 to 48% at year 25.…”

Section: Post-stroke Dementiamentioning

confidence: 99%

“…144 As shown in Table 6, 5.5 to 16.3% of patients admitted for stroke seem to have had undetected pre-existing progressive cognitive decline. 138,142,[144][145][146][147] Risk factors for post-stroke dementia At least three different groups of factors, each acting independently, rather than a single pathophysiological mechanism probably contribute to the development of post-stroke dementia: 111,148 (1) stroke-related factors such as the location and the severity of the brain lesions; 149,150 (2) the overall cardiovascular risk profile as determined by the presence of atrial fibrillation 140 or diabetes mellitus; 149 (3) non-strokerelated factors similar to those found in Alzheimer's disease including increasing age, 149,151 low education, 149 cortical atrophy. 145,152 Hypertension has been identified as a risk factor by Pohjasvaara et al (1998), 111 but not by Skoog et al (1996).…”

Section: Post-stroke Dementiamentioning

confidence: 99%

Cerebral complications of hypertension

Rigaud

Staessen

et al. 2000

J Hum Hypertens

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Ischaemic and degenerative brain diseases are a major health problem leading to a devastating loss of autonomy. Hypertension has been shown to carry an increased risk not only for cerebrovascular morbidity and mortality but also for cognitive impairment and dementia. Although diastolic blood pressure is considered an important risk factor, it is now clear that isolated systolic hypertension and elevated pulse pressure also play an important role in the development of brain complications. Therefore the treatment of these conditions must urgently become a widespread tool of prevention. All the randomised placebo-controlled trials completed for the last 30 years have shown a reduction in fatal and/or non-fatal strokes. In the most recent trials in isolated systolic hypertension in older patients, the benefit was even greater because of the higher risk in these populations. The new classes of drugs, in particular, calcium-channels blockers and angiotensin-

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Dementia After First Stroke

Cited by 183 publications

References 43 publications

Risk factors associated with post-stroke dementia: a systematic review and meta-analysis

Risk factors associated with post-stroke dementia: a systematic review and meta-analysis

CKD Associates with Cognitive Decline

Cerebral complications of hypertension

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