Previous and Incident Dementia as Risk Factors for Mortality in Stroke Patients

Barba, Raquel; Morin, Maria-del-Mar; Cemillán, Carlos; Delgado, Carlos; Domingo, J; Ser, Teodoro del

doi:10.1161/01.str.0000017285.73172.91

Cited by 82 publications

(88 citation statements)

References 37 publications

(24 reference statements)

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“…2 Dementia was not related to incidence of first-ever stroke in our study, but some other studies have reported an increased incidence of stroke in demented individuals. 19,20 Our finding is remarkable because depression is difficult to assess in demented individuals. Support for the validity of the diagnosis is that all individuals were assessed by a psychiatrist during a 1.5-hour examination.…”

Section: Liebetrau Et Al Depression As a Risk Factor For Strokementioning

confidence: 80%

Depression as a Risk Factor for the Incidence of First-Ever Stroke in 85-Year-Olds

Liebetrau¹,

Steen²,

Skoog³

2008

Stroke

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Background and Purpose-Depression may increase the risk for stroke. Few studies have examined whether depression increases the risk for stroke in the very old and among the demented. We examined the relation between depression in 85-year-olds and the 3-year incidence of first-ever stroke. Methods-A representative sample of 494 85-year-olds (147 demented, 347 nondemented) in Gothenburg, Sweden, was examined with psychiatric examinations and key informant interviews. Diagnoses of depression and dementia were made according to the Diagnostic and Statistical Manual of Mental Disorders, Third Revision. The sample was followed for 3 years regarding the incidence of stroke. Information on stroke was obtained from the Swedish Hospital Discharge Register, death certificates, self-reports, and key informants. Those with known stroke history at baseline (nϭ93) were excluded from the incidence study. Results-The prevalence of depression at age 85 was 19%. Depression at baseline (hazard ratio, 2.7; 95% CI, 1.5 to 4.7;Pϭ0.0006) and systolic blood pressure (hazard ratio, 1.014 per 1 mm Hg; 95% CI, 1.00 to 1.03; Pϭ0.019) were related to increased incidence of first-ever stroke during follow-up. Depression increased stroke risk both among demented and nondemented individuals. Among the symptoms of depression, only depressed mood was an independent predictor of incidence first-ever stroke in multivariate analyses. Stroke history at age 85 was not associated with clinical depression. Conclusions-Depression and stroke are both common in elderly populations. The finding that depression increases risk for first-ever stroke indicates that detection and treatment of depression may have implications for stroke prevention.

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Section: Liebetrau Et Al Depression As a Risk Factor For Strokementioning

confidence: 80%

Depression as a Risk Factor for the Incidence of First-Ever Stroke in 85-Year-Olds

Liebetrau¹,

Steen²,

Skoog³

2008

Stroke

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“…This likely reflects both the higher risk of dementia as a consequence of stroke and the higher rate of mortality in individuals with stroke and dementia. Prestroke and poststroke dementia are risk factors for mortality in patients with stroke, 34 and so participants of longitudinal studies with a history of stroke are likely to have been among those stroke survivors with a lower risk of dementia incidence.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological Studies of the Effect of Stroke on Incident Dementia

Savva

Stephan

2010

Stroke

249

151

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Background and Purpose-Stroke is implicated in the incidence of dementia, and the risk of poststroke dementia is well characterized, but the excess risk of dementia in those with stroke compared with those without stroke is not well known. Methods-We conducted a systematic review of the excess risk of incident dementia conferred by stroke. Studies of the risk of incident dementia in the population with stroke compared with the population without stroke were identified and compared. Results-Sixteen studies were identified with all but one conducted in a community setting. A history of stroke doubles the risk of incident dementia in the older population. This increase is not explained by demographic or cardiovascular risk factors or by prestroke cognitive decline. The excess risk of incident dementia diminishes with time after stroke and may be higher in those without an APOE ⑀4 allele. There is no excess risk of incident dementia in those aged Ͼ85 years with a history of stroke compared to those aged Ͼ85 years without stroke. Conclusions-The effect of stroke on dementia incidence in the population is not explained by common risk factors. At this time of population aging and increased stroke survival, more research is needed to determine to what extent efforts to reduce the incidence of stroke will affect the incidence of dementia. (Stroke. 2010;41:e41-e46.)

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“…11 Standardized questionnaires such as the Informant Questionnaire on Cognitive Decline in the Elderly enable the assessment of prestroke cognitive status in order to differentiate new-onset PSCI from prestroke conditions. 12,13 Prestroke dementia has been shown to associate with medial temporal lobe atrophy and family history.…”

Section: Course and Prognosis Of Poststroke Cognitive Disordersmentioning

confidence: 99%

Poststroke cognitive impairment and dementia: prevalence, diagnosis, and treatment

Melkas¹,

Jokinen²,

Hietanen³

et al. 2014

DNND

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Three aspects of poststroke cognitive impairment and dementia are discussed in this review: prevalence; diagnosis; and treatment. The aim is to increase awareness of poststroke cognitive impairment in order to further stimulate strategies to recognize the condition and to prevent its progression. Approximately two-thirds of all middle-aged and elderly stroke patients develop cognitive impairment, and one in three develops dementia. The standard reference for diagnosis is a detailed neuropsychological examination. Short screening tests have been used for both clinical and research purposes, but their sensitivity is limited and there is no consensus as to which test is the most appropriate. The treatment of poststroke cognitive impairment and dementia is based on effective treatment of vascular risk factors, including lifestyle modification when needed.

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Previous and Incident Dementia as Risk Factors for Mortality in Stroke Patients

Cited by 82 publications

References 37 publications

Depression as a Risk Factor for the Incidence of First-Ever Stroke in 85-Year-Olds

Depression as a Risk Factor for the Incidence of First-Ever Stroke in 85-Year-Olds

Epidemiological Studies of the Effect of Stroke on Incident Dementia

Poststroke cognitive impairment and dementia: prevalence, diagnosis, and treatment

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