Predictors of Poststroke Dementia: Results of a Hospital-Based Study in Poland

Abstract

Dementia affects up to 30% of stroke survivors 3 months after stroke. The goal of this study was to determine the risk factors of poststroke dementia (PSD) in a cohort of consecutive stroke patients in Poland. A standard stroke evaluation was conducted on admission in 220 consecutive patients with ischemic/hemorrhagic stroke after excluding 30 (12%) patients with prestroke dementia. After 3 months, the survivors completed a comprehensive neuropsychological examination. The DSM-IV definition was used for diagnosis of dementia. Dementia was diagnosed in 44 (22.6%) patients 3 months after stroke. In logistic regression analysis, age (OR 1.08, 95% CI 1.04–1.14, p < 0.001), diabetes mellitus (OR 2.67, 95% CI 1.06–6.57, p = 0.03) and neurological deficit on admission (OR 0.92, 95% CI 0.89–0.96, p < 0.001) were independently associated with PSD in the Polish hospital-based population.

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

“…Fifteen abstracts were excluded because the result no associated with poststroke dementia, thirteen articles cannot calculate the data for the relative risks of dementia in stroke patients. The remaining 8 articles 20,21,23,[26][27][28][29][30] selected by the selection criteria can be calculated to identify the relative risks of dementia, as shown in Figure 1. Table 1 shows the demographic details of hospital-based and population-based studies of dementia after stroke such as study design, and methods used to measure dementia in all the publications that were relevant to the eligible hospital-based and population-based studies of dementia after stroke.…”

“…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).…”

“…31 Cognitive impairment before stroke risk of dementia after stroke showed that cognitive impairment before stroke was associated with potential covariates and diagnosis of poststroke dementia in the Helsinki Stroke Ageing Memory study cohort (OR 5.76, 95%CI; 2.84 to 11.70). 10 Second, vascular risk factors such as diabetes mellitus were associated with an increased risk of dementia in stroke patients 10,11,16,[20][21][22]24,32 who had history of diabetes mellitus associated with incident demen- tia (OR 1.90, 95%CI; 1.15 to 3.16). 20 Hypertension was independently associated with the risk of post-stroke dementia.…”

“…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.…”

“…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.…”