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

Abstract

This study aimed to evaluate the risk factors for prognostic of post-stroke dementia (PSD). A systematic review included case-control and/or cohort studies, we searched both published and unpublished literatures between 2000 to July 31, 2016. Two authors independently screened and selected research articles. If another one disagreed, the third author would be just along with his/her professionally. Moreover, Critical appraisal was measured by the quality (GRADE). Data collection was in the data extraction form. The Rev-Man 5.3 was used to estimate pooled data. The fixed-effect model will be used when the heterogeneity I² <50%, whereas the random-effects model will be used when the heterogeneity I²>50%. Result eight publications were pooled for measuring an association between risk factors and PSD by meta-analysis. There were 6 strongly PSD risk factors. The pooled relative ratio (RR) of atrial fibrillation was 1.68, previous stroke 1.59, myocardial infarction 1.40, hypertension 1.36, diabetes mellitus 1.25 and previous transient ischemic attack 1.25 respectively. Un-pooled data from 13 publications reported that the risk factors for dementia in stroke patients were i) demographic factors, ii) vascular risk factors, iii) stroke factors, iv) stroke complications, and v) abnormalities on brain imaging. Strongly risk factors associated with increasing PSD risk were atrial fibrillation, previous stroke, myocardial infarction, hypertension, diabetes mellitus, and previous transient ischemic attack. Further studies, strongly risk factors need to investigate and develop the risk score for the prediction of dementia in stroke patients.

Amyloid pathology in the brain after ischemia

“…The level of serum amyloid growth correlated negatively with the clinical improvement after ischemia-reperfusion brain injury, which in turn reflected the severity of ischemic injury [91] and/or the development of recurrent ischemic stroke [47]. We can conclude that the proteomic and genomic changes associated with Alzheimer's disease contribute to brain ischemia-reperfusion neurodegeneration [72] with the development of the dementia [7,9,13,15,28,29,34,75,81].…”

From Stroke to Dementia: a Comprehensive Review Exposing Tight Interactions Between Stroke and Amyloid-β Formation

“…Post-stroke dementia develops in up to a third of patients within a year after stroke, which is strongly associated with advanced aging [124]. Memory disturbance can be due to the stroke event itself or due to AD, and the two kinds of cognitive impairments may also coexist [125].…”

“…Other risk factors affecting cerebrovascular integrity and involved in post-stroke dementia are atrial fibrillation, previous stroke event, myocardial infarction, diabetes mellitus, and previous transient ischemic attack [125]. Also, hypertension, which is a common risk factor for stroke and AD, has been shown to worsen Aβ-induced neurovascular dysfunction and to promote β-secretase activity.…”

Leisure activity and social integration mitigate the risk of dementia related to cardiometabolic diseases: A population‐based longitudinal study

“…Individual CMDs have been associated with the risk for dementia. Diabetes nearly doubles dementia risk, whereas coronary heart disease and heart failure are related to a 27% to 60% increased risk, and stroke confers a 1.59‐fold increased risk . However, evidence about the magnitude of dementia risk in older adults who have more than one CMD remains unclear.…”