Prestroke Dementia

Barba, Raquel; Castro, Miguel; Morín, María del Mar; Rodríguez-Romero, Rafael; Rodriguez-García, Elena; Cantón, Rafael; Ser, Teodoro del

doi:10.1159/000047642

Cited by 56 publications

(52 citation statements)

References 23 publications

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“…For this longitudinal study, we excluded 63 patients (19.2%) who died before the third month after stroke, 32 (9.8%) who were demented before stroke, 6 and 39 (11.9%) who did not attend any of the scheduled follow-up visits (29; 8.8%) or had an inadequate baseline evaluation (10; 3%). The present prospective study included 193 patients.…”

Section: Patientsmentioning

confidence: 99%

Evolution of Cognitive Impairment After Stroke and Risk Factors for Delayed Progression

Ser

Barba²,

Morin³

et al. 2005

Stroke

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143

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Section: Patientsmentioning

confidence: 99%

Evolution of Cognitive Impairment After Stroke and Risk Factors for Delayed Progression

Ser

Barba²,

Morin³

et al. 2005

Stroke

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143

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“…[12][13][14] Hospital based 15 and population based studies 16 have shown that patients with dementia have an increased risk of seizures compared with the general population. However, the question of whether stroke patients with pre-existing dementia are at increased risk for poststroke seizures has never been investigated.…”

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confidence: 99%

Influence of pre-existing dementia on the risk of post-stroke epileptic seizures

Cordonnier

2005

Journal of Neurology, Neurosurgery & Psychiatry

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Background: Seizures occur in 10% of stroke patients, but their predictors have not been clearly identified. Pre-existing dementia is present in 12-16% of stroke patients and, at the community level, patients with dementia have increased risk of seizures. However, the question of whether pre-existing dementia is associated with a higher risk of seizures after stroke has never been studied. Aim: To evaluate whether pre-existing dementia is associated with an increased risk of seizures after stroke. Methods: The study was conducted on 202 consecutive stroke patients recruited to the Lille stroke/ dementia study (97 men; median age, 75 years; range, 42-100). Pre-stroke cognitive functions were evaluated using the Informant Questionnaire on Cognitive Decline in the Elderly, with a cutoff value of 104 for the diagnosis of dementia. Seizures were defined as early seizures when occurring within seven days of stroke onset, and as late seizures when occurring more than seven days after stroke. Results: Of 202 patients, 33 (16.3%) met the criteria for pre-existing dementia, and 11 (5.4%) developed early seizures. During 289 person-years of follow up, 14 patients developed late seizures, resulting in an incidence rate of 4.8 new cases/100 person-years. Pre-existing dementia was not associated with the occurrence of early seizures, but was independently associated with the occurrence of late seizures (adjusted odds ratio, 4.66; 95% confidence interval, 1.34 to 16.21). Conclusion: Stroke patients with pre-existing dementia have an increased risk of late seizures. Any factor increasing the risk of seizures (drugs, metabolic changes) should be avoided in these patients.

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“…6 -14 Recent studies have also demonstrated that many stroke patients seem to have preexisting cognitive decline, and one sixth of them have previous dementia. [15][16][17] Dementia is a cause of morbidity/mortality in the elderly and is a risk factor for adverse outcomes; it reduces life expectancy independently of its etiology. 18,19 In a previous study, Tatemichi et al 20 demonstrated that dementia adversely influences long-term survival after stroke; however, it is unknown whether mortality is determined by dementia that precedes stroke or that appears just after it.…”

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

Barba

Morin

Cemillán

et al. 2002

Stroke

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Background and Purpose-We sought to determine whether previous or incident dementia increases the risk of mortality after stroke. Methods-We assessed clinical, functional, and cognitive status in 324 consecutive stroke patients who were followed up for 24 months. Prestroke dementia was diagnosed at admission (Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition criteria) and poststroke dementia 3 months after stroke (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria). The proportion of patients surviving in the groups with and without dementia and the relative risk of mortality were calculated with Kaplan-Meier and with Cox proportional hazards analyses, respectively, for prestroke, stroke-related, and poststroke dementia. Results-Forty-nine patients (15.1% of the total sample) were found to have prestroke dementia. Three months after stroke, 75 cases had poststroke dementia: 50 incident cases (20% of 251 reexamined cases) with stroke-related dementia and 25 already demented before the stroke. After a mean follow-up of 16.1Ϯ9.9 months, the proportion of survivors was 20.4% in patients with and 72.6% in those without prestroke dementia. After a mean follow-up of 22.1Ϯ6.7 months, the proportion of survivors was 58.3% in patients with and 95.4% in those without stroke-related dementia. Using multivariate analysis and adjusting for age, sex, hypertension, diabetes, previous stroke, heart disease, and severity and recurrence of stroke, we found the relative risk of mortality associated with prestroke dementia to be 2.1 (95% CI, 1.2 to 3.6), with stroke-related dementia 6.3 (95% CI, 2.3 to 17.3), and with poststroke dementia 8.5 (95% CI, 3.4 to 20.9). Conclusions-Both previous dementia and incident dementia adversely influence long-term survival after stroke, even after adjustment for other predictors of stroke mortality. (Stroke.

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Prestroke Dementia

Cited by 56 publications

References 23 publications

Evolution of Cognitive Impairment After Stroke and Risk Factors for Delayed Progression

Evolution of Cognitive Impairment After Stroke and Risk Factors for Delayed Progression

Influence of pre-existing dementia on the risk of post-stroke epileptic seizures

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

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