Stroke severity predicts poststroke delirium and its association with dementia: Longitudinal observation from a low income setting

Ojagbemi, Akin; Owolabi, Mayowa; Bello, Toyin; Baiyewu, Olusegun

doi:10.1016/j.jns.2017.02.039

Cited by 28 publications

(25 citation statements)

References 38 publications

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“…Consistent with other studies, both in LMIC (35) and HIC (36), stroke was a strong predictor of dementia, particularly in the younger age group. Similar to previous Latin American studies, diabetes was not associated with dementia (37).…”

Section: Health Factorssupporting

confidence: 91%

Risk Factors for Incident Dementia Among Older Cubans

Peeters

Sanchez

Guerra

et al. 2020

Front. Public Health

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Introduction: Little is known about risk factors of dementia in Latin American countries. We aimed to identify socio-demographic, health and lifestyle risk factors of incident dementia in Cuban older adults. Methods: Data were from 1,846 participants in the Cuban cohort of the 10/66 Dementia Research Group. Participants completed questionnaires, health examinations, and cognitive tests at baseline (2003-2006) and 4.5 years later (2007-2010). Associations between risk factors (baseline) and incident dementia (follow-up) were examined using logistic regression. Results: Just over 9% of participants developed dementia. Overall, older age and low physical activity were associated with incident dementia. In those 65-74 years of age, depression, stroke and low physical activity were associated with incident dementia. In those ≥75 years of age, low physical activity, never eating fish, and smoking were associated with incident dementia. Conclusions: Modifiable lifestyle factors play an important role in developing dementia in Cuban older adults. This knowledge opens up opportunities for preventive strategies.

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Section: Health Factorssupporting

confidence: 91%

Risk Factors for Incident Dementia Among Older Cubans

Peeters

Sanchez

Guerra

et al. 2020

Front. Public Health

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“…A total of 134 articles were read in full length and 30 were included in the review. 15-44 In these 30 articles, 24 unique populations were identified (Figure 1). The discrepancy between the number of articles and the number of unique populations was caused by the fact that the same population was described in more than one article.…”

Section: Resultsmentioning

confidence: 99%

Delirium Assessment in Acute Stroke: A Systematic Review and Meta-Analysis of Incidence, Assessment Tools, and Assessment Frequencies

Stokholm

Steenholt

Csilag

et al. 2019

J Cent Nerv Syst Dis

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Purpose: The purpose of this systematic literature review was to examine whether different assessment methods contribute to the variance in delirium incidence detected in populations of patients with acute stroke. Specifically, the aim was to address the influence of (1) choice of assessment tool, (2) frequency of assessment, and (3) type of health professional doing the assessment. Methods: We searched MEDLINE, EMBASE, and PsycINFO and included pro- and retrospective cohort studies assessing delirium during hospitalization of adult acute stroke patients. Results: In 30 articles, 24 unique populations were identified and included in the review. Delirium incidence ranged from 1.4% to 75.6% in total and a chi-square test showed a significant heterogeneity across studies (χ2 = 536.5, df = 23, P < .0001). No studies had an assessment for delirium before a patient entered the study. No specific patterns regarding the influence of tool, assessment frequency or health professional were discernible. Discussion: Subgroups analyses were not conducted due to the heterogeneity across studies. Studies comparing delirium assessment tools directly with each other are needed. Conclusions: Delirium is a common complication in acute stroke. No firm conclusions about a possible correlation of choice of tool, assessment frequency, and delirium incidence could be made due to the great heterogeneity of the study populations. Only 1 study compared 2 tools directly with each other. Further studies comparing delirium assessment tools directly with each other are needed.

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“…These reports suggest that nearly 50% of older West African stroke survivors develop cognitive impairment or dementia. More than 30% of stroke survivors may develop delirium within days after the stroke majority 66% of which is hypoactive [101]. Those with severe stroke injury and developing were more prone to succumb to dementia or early death.…”

Section: Vascular Cognitive Impairment Vascular Cognitive Disorders mentioning

confidence: 99%

Stroke, cerebrovascular diseases and vascular cognitive impairment in Africa

Akinyemi

Owolabi

Ihara

et al. 2019

Brain Research Bulletin

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With increased numbers of older people a higher burden of neurological disorders worldwide is predicted. Stroke and other cerebrovascular diseases do not necessarily present with different phenotypes in Africa but their incidence is rising in tandem with the demographic change in the population. Age remains the strongest irreversible risk factor for stroke and cognitive impairment. Modifiable factors relating to vascular disease risk, diet, lifestyle, physical activity and psychosocial status play a key role in shaping the current spate of stroke related diseases in Africa. Hypertension is the strongest modifiable risk factor for stroke but is also likely associated with co-inheritance of genetic traits among Africans. Somewhat different from high-income countries, strokes attributed to cerebral small vessel disease (SVD) are higher >30% among sub-Saharan Africans. Raised blood pressure may explain most of the incidence of SVD-related strokes but there are likely other contributing factors including dyslipidaemia and diabetes in some sectors of Africa. However, atherosclerotic and cardioembolic diseases combined also appear to be common subtypes as causes of strokes. Significant proportions of cerebrovascular diseases are ascribed to various forms of infectious disease including complications of human immunodeficiency virus. Cerebral SVD leads to several clinical manifestations including gait disturbance, autonomic dysfunction and depression. Pathological processes are characterized by arteriolosclerosis, lacunar infarcts, perivascular spaces, microinfarcts and diffuse white matter changes, which can now all be detected on neuroimaging. Except for isolated cases of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy or CADASIL, hereditary arteriopathies have so far not been reported in Africa. Prevalence estimates of vascular dementia (2-3%), delayed dementia after stroke (10-20%) and vascular cognitive impairment (30-40%) do not appear to be vastly different from those in other parts of the world. However, given the current demographic transition in both urban and rural settings these figures will likely rise. Wider application of neuroimaging modalities and implementation of stroke care in Africa will enable better estimates of SVD and other subtypes of stroke. Stroke survivors with SVD type pathology are likely to have low mortality and therefore portend increased incidence of dementia.

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Stroke severity predicts poststroke delirium and its association with dementia: Longitudinal observation from a low income setting

Cited by 28 publications

References 38 publications

Risk Factors for Incident Dementia Among Older Cubans

Risk Factors for Incident Dementia Among Older Cubans

Delirium Assessment in Acute Stroke: A Systematic Review and Meta-Analysis of Incidence, Assessment Tools, and Assessment Frequencies

Stroke, cerebrovascular diseases and vascular cognitive impairment in Africa

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