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Original Paper

Cognitive Impairment and Dementia 20 Months after Stroke

Lindén T.a · Skoog I.b · Fagerberg B.c · Steen B.d · Blomstrand C.a

Author affiliations

aStroke Research Group and bNeuroepidemiology Group, Department of Clinical Neuroscience, cDepartment of Internal Medicine and dDepartment of Geriatric Medicine, Sahlgrenska University Hospital, Göteborg, Sweden

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Neuroepidemiology 2004;23:45–52

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: January 23, 2004
Issue release date: January – April

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 4

ISSN: 0251-5350 (Print)
eISSN: 1423-0208 (Online)

For additional information: https://www.karger.com/NED

Abstract

Background and Purpose: Dementia is common after stroke, but the dementia syndrome does not cover the whole spectrum of cognitive impairment. Our aim was to quantify and compare dementia and cognitive impairments in elderly patients 1.5 years after stroke and a matched normal population. Subjects and Methods: We examined dementia and cognitive impairments in 149 out of an initial total of 243 acute stroke patients after a mean 20 months. Inclusion criteria were age ≧70 years, not living in an institution and no previous cerebral lesion. The patients’ mean age was 81 years. Five controls matched by age and gender and fulfilling the same exclusion criteria were selected for each patient (n = 745) from a population-based survey in the same area. Dementia was diagnosed according to the DSM-III-R criteria, and impairments in different dimensions of cognitive function were assessed. Results: The prevalence of dementia was 28% in the stroke patients and 7.4% in the controls (OR 4.7; 95% CI 3.0–7.5). Seventy-two percent of the patients had cognitive impairments compared to 36% in the controls. Cognitive impairments were more common in nondemented stroke patients than in nondemented controls: 61 vs. 31% (OR 3.5; 95% CI 2.3–5.3). The risk increase attributable to stroke was highest for patients below 80 years of age. Conclusions: Stroke confers an increased risk of dementia and cognitive impairments in the elderly, especially in the younger ones. Apraxia is the most frequent neuropsychiatric impairment after stroke. The concept of dementia does not describe cognitive impairments well, since it underestimates their extent not only after stroke but also in normal ageing.

© 2004 S. Karger AG, Basel


References

  1. Adams GF, Hurwitz LJ: Mental barriers to recovery from strokes. Lancet 1963;2:533–537.
    External Resources
  2. Ebrahim S, Barer D, Nouri F: An audit of follow-up services for stroke patients after discharge from hospital. Int Disabil Stud 1987;9:103–105.
  3. Wade DT, Parker V, Langton Hewer R: Memory disturbance after stroke: Frequency and associated losses. Int Rehabil Med 1986;8:60–64.
  4. Tinson DJ, Lincoln NB: Subjective memory impairment after stroke. Int Disabil Stud 1987;9:6–9.
  5. Ladurner G, Iliff LD, Lechner H: Clinical factors associated with dementia in ischaemic stroke. J Neurol Neurosurg Psychiatry 1982;45:97–101.
  6. Kotila M, et al: Dementia after stroke. Eur Neurol 1986;25:134–140.
  7. Tatemichi TK, et al: Dementia after stroke: Baseline frequency, risks, and clinical features in a hospitalized cohort. Neurology 1992;42:1185–1193.
  8. Tatemichi TK, et al: Dementia after stroke is a predictor of long-term survival. Stroke 1994;25:1915–1919.
  9. Poungvarin N, et al: Dementia in Thai stroke survivors: Analysis of 212 patients. J Med Assoc Thai 1995;78:337–343.
  10. Censori B, et al: Dementia after first stroke. Stroke 1996;27:1205–1210.
  11. Kokmen E, et al: Dementia after ischemic stroke: A population-based study in Rochester, Minnesota (1960–1984). Neurology 1996;46:154–159.
  12. Henon H, et al: Preexisting dementia in stroke patients: Baseline frequency, associated factors, and outcome. Stroke 1997;28:2429–2436.
  13. Pohjasvaara T, et al: Dementia three months after stroke: Baseline frequency and effect of different definitions of dementia in the Helsinki Stroke Aging Memory Study (SAM) cohort. Stroke 1997;28:785–792.
  14. Kase CS, et al: Intellectual decline after stroke: The Framingham Study. Stroke 1998;29:805–812.
  15. Henon H, et al: Poststroke dementia: Incidence and relationship to prestroke cognitive decline. Neurology 2001;57:1216–1222.
  16. Pohjasvaara T, et al: Clinical determinants of poststroke dementia. Stroke 1998;29:75–81.
  17. Bornstein NM: The Tel Aviv Stroke Registry: 3,600 consecutive patients. Stroke 1996;27:1770–1773.
  18. Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R). Washington, American Psychiatric Association, 1987.
  19. Rockwood K, et al: Diagnosis of vascular dementia: Consortium of Canadian Centres for Clinical Cognitive Research concensus statement. Can J Neurol Sci 1994;21:358–364.
  20. Ritchie K: The screening of cognitive impairment in the elderly: A critical review of current methods. J Clin Epidemiol 1988;41:635–643.
  21. Bowler JV, Hachinski V: Vascular cognitive impairment: A new approach to vascular dementia. Baillieres Clin Neurol 1995;4:357–376.
  22. Hier DB, et al: Stroke recurrence within 2 years after ischemic infarction. Stroke 1991;22:155–161.
  23. Galski T, et al: Predicting length of stay, functional outcome and aftercare in the rehabilitation of stroke patients: The dominant role of higher-order cognition. Stroke 1993;24:1794–1800.
  24. Katzman R, et al: The malignancy of dementia: Predictors of mortality in clinically diagnosed dementia in a population survey of Shanghai, China. Arch Neurol 1994;51:1220–1225.
  25. Paykel ES, Huppert FA, Brayne C: Incidence of dementia and cognitive decline in over-75s in Cambridge: Overview of cohort study. Soc Psychiatry Psychiatr Epidemiol 1998;33:387–392.
  26. Brayne C, et al: Vascular risks and incident dementia: Results from a cohort study of the very old. Dement Geriatr Cogn Disord 1998;9:175–180.
  27. Fagerberg B, et al: Effect of acute stroke unit care integrated with care continuum versus conventional treatment: A randomized 1-year study of elderly patients: The Göteborg 70+ Stroke Study. Stroke 2000;31:2578–2584.
    External Resources
  28. Steen B, Djurfeldt H: The gerontological and geriatric population studies in Gothenburg, Sweden. Z Gerontol 1993;26:163–169.
  29. Palsson S, et al: The prevalence of depression in relation to cerebral atrophy and cognitive performance in 70- and 74-year-old women in Gothenburg. The Women’s Health Study. Psychol Med 2001;31:39–49.
  30. Skoog I, et al: A population-based study of dementia in 85-year-olds. N Engl J Med 1993;328:153–158.
  31. Rosen J, et al: The Delirium Rating Scale in a psychogeriatric inpatient setting. J Neuropsychiatry Clin Neurosci 1994;6:30–35.
  32. Inzitari D, et al: Incidence and determinants of poststroke dementia as defined by an informant interview method in a hospital-based stroke registry. Stroke 1998;29:2087–2093.
  33. Desmond DW, et al: Dementia as a predictor of adverse outcomes following stroke: An evaluation of diagnostic methods. Stroke 1998;29:69–74.
  34. Erkinjuntti T, et al: The effect of different diagnostic criteria on the prevalence of dementia. N Engl J Med 1997;337:1667–1674.
  35. Bowler JV, Hachinski V: Vascular cognitive impairment: A new approach to vascular dementia. Baillieres Clin Neurol 1995;4:357–376.
  36. Bowler JV, Hadar U, Wade JP: Cognition in stroke. Acta Neurol Scand 1994;90:424–429.
  37. Bowler JV, Eliasziw M, Steenhuis R, Munoz DG, Fry R, Merskey H, Hachinski VC: Comparative evolution of Alzheimer disease, vascular dementia, and mixed dementia. Arch Neurol 1997;54:697–703.
  38. Tatemichi TK, Desmond DW, Stern Y, Paik M, Sano M, Bagiella E: Cognitive impairment after stroke: Frequency, patterns, and relationship to functional abilities. J Neurol Neurosurg Psychiatry 1994;57:202–207.
  39. Naver HK, Blomstrand C, Wallin BG: Reduced heart rate variability after right-sided stroke. Stroke 1996;27:247–251.
  40. Moroney JT, et al: Treatment for the secondary prevention of stroke in older patients: The influence of dementia status. J Am Geriatr Soc 1999;47:824–829.
  41. Ferrucci L, et al: Apolipoprotein E epsilon 2 allele and risk of stroke in the older population. Stroke 1997;28:2410–2416.
  42. Pasquir F, Leys D: Why are stroke patients prone to develop dementia? J Neurol 1997;244:135–142.
  43. Snowdon DA, et al: Brain infarction and the clinical expression of Alzheimer disease. The Nun Study. JAMA 1997;277:813–817.
  44. Zhu L, et al: Incidence of stroke in relation to cognitive function and dementia in the Kungsholmen Project. Neurology 2000;54:2103–2107.
  45. Peltonen M, Stegmayr B, Asplund K: Time trends in long-term survival after stroke: The Northern Sweden Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) study, 1985–1994. Stroke 1998;29:1358–1365.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: January 23, 2004
Issue release date: January – April

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 4

ISSN: 0251-5350 (Print)
eISSN: 1423-0208 (Online)

For additional information: https://www.karger.com/NED


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