Poststroke Dementia

Abstract

The association between stroke and dementia is frequent. The prevalence of poststroke dementia (PSD) ranges from 6 to 32%, depending on the population studied, the criteria used for the diagnosis of dementia, and the time interval between the stroke and the neuropsychological assessment. The risk of PSD is high immediately after stroke and remains higher than in controls in stroke patients nondemented 3 months after stroke. Not all cases of PSD are vascular in origin, with about one third of demented patients diagnosed as having Alzheimer’s disease plus stroke. The pathophysiology of PSD is probably multifactorial, with an influence of vascular lesions, associated Alzheimer’s lesions and white matter changes. The risk of dementia is higher in older patients and in patients with preexisting cognitive decline – no dementia, severe stroke, a history of stroke, white matter changes and cerebral atrophy. The influence of stroke location, vascular risk factors and silent infarcts remains to be determined. PSD adversely influences the outcome in stroke patients.

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

“…First, demographics and clinical characteristics of patients which showed increasing age associated with an increased risk of poststroke dementia in most studies. 16,[18][19][20][21]23,25,32 Adding demographics factors showed that the risk of incident dementia elevated in relation to older age especially > 80 years (RR 4.66, 95%CI; 2.36 to 9.22) and age 70 to 79 years (RR 2.68, 95%CI; 1.52 to 4.74) versus age 60 to 69 years. 28 33 Previous mental decline was the correlation of dementia in logistic regression analysis (OR 1.20, 95%CI; 1.10 to 1.40).…”

“…26 Third, stroke factors such as the previous stroke has been indicated as a risk factor for poststroke dementia. 11,18,22 A study on frequency and predictors of dementia after ischemic stroke showed that prior stroke was independent predictors of dementia (OR 2.53, 95%CI; 1.42 to 4.51). 26 Recurrence stroke risk factors were significantly associated with post-stroke dementia.…”

“…3 This may result from stroke and Alzheimer's disease or from other factors 16,17 such as aging, low education level, diabetes mellitus, atrial fibrillation, myocardial infarction, hypertension, medial temporal lope atrophy and white matter changes. 10,11,16,[18][19][20][21][22][23][24][25] Currently, dementia is considered untreatable, and there are many factors that cause dementia. The previous study was unable to identify the factors that affect directly.…”

Cognitive Disorder After Stroke

“…В целом, по данным эпидемиологических исследований, распространенность КН после инсульта составляет от 22% до 96%, такой большой разброс объяс-няется неоднородностью популяции пациентов, выбором разных методик нейропсихологического обследования, включением в анализ доинсультных КН или их игнориро-ванием, выбором критериев исключения (афазия, первый или повторный инсульт и т.п.) [11,16,17]. К настоящему времени разработан специальный опросник, позволяю-щий сделать ретроспективное предположение о наличии доинсультного когнитивного снижения на основании бесе-ды с родственниками пациента («опросник родственника о когнитивном снижении у пожилого человека» -Informant Questionnaire on Cognitive Decline in Elderly -IQCODE) [18].…”

A comparative clinical study of the effectiveness of computer cognitive training in patients with post-stroke cognitive impairments without dementia

“…There is little evidence to suggest that executive function interventions have the potential to improve aspects of executive functioning in adults with stroke (Poulin, Korner-Bitensky, & Dawson, 2013). Evaluating the efficacy of different cognitive rehabilitation methods and approaches is very difficult due to differences in patients' ages, brain injuries, and cognitive dysfunctions, as well as the difficulties of conducting randomized clinical trials in this field (Hénon et al, 2001).…”