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Risk Of Dementia High Among Ischemic Stroke Patients

Risk of incident dementia is high among patients who have suffered ischemic stroke.

The risk is particularly high among ischemic stroke patients who also have intercurrent medical illnesses associated with cerebral hypoxia or ischemia.

Previous epidemiological studies have suggested that as many as one fourth of elderly patients have dementia three months following ischemic stroke. However, few longitudinal studies have been conducted to determine the incidence of dementia after ischemic stroke.

Investigators from the Departments of Neurology and Pathology at SUNY Downstate Medical Center in Brooklyn, New York, United States, conducted a longitudinal study including 334 ischemic stroke patients aged 70.4 ± 7.5 years and 241 control subjects.

All patients underwent annual neurological, neuropsychological and functional tests. None of the patients had dementia at the time of baseline examinations.

Results showed a crude incidence rate of dementia of 8.49 cases per 100 person-years among the ischemic stroke patients. Among the control subjects, the rate was 1.37 cases per 100 person-years.

The relative risk of incident dementia was 3.83 according to a Cox proportional-hazards analysis that adjusted for demographic variables and baseline Mini-Mental State Examination score.

Intercurrent medical illnesses that might cause cerebral hypoxia or ischemia were independently related to incident dementia resulting in a relative risk ratio of 4.40.

This suggests that cerebral hypoperfusion may be the basis of dementia after ischemic stroke in some patients, according to the investigators.
Stroke 2002; 33(9): 2254-2262 "Incidence of dementia after ischemic stroke: results of a longitudinal study."

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