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Long-term cognitive transitions, rates of cognitive change, and predictors of incident dementia in a population-based first-ever stroke cohort

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Srikanth, VK and Quinn, SJ and Donnan, G and Saling, M and Thrift, AG (2006) Long-term cognitive transitions, rates of cognitive change, and predictors of incident dementia in a population-based first-ever stroke cohort. Stroke, 37 (10). pp. 2479-2483. ISSN 0039-2499

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Abstract

Background and Purpose— There are few data on long-term cognitive outcomes after first-ever stroke. We aimed to study long-term cognitive transitions, rates of cognitive change, and factors associated with incident dementia and cognitive impairment–no dementia (CIND) 2 years after first-ever stroke. Methods— A population-based cohort of incident first-ever stroke cases (n=99; mean age, 69.9 years) and an age- and sex-matched comparison group (nonstrokes, n=99) were followed up for 2 years by 3 serial examinations. Rates of cognitive change were compared by repeated-measures analyses. Factors associated with incident dementia and CIND at 2 years were determined by multinomial logistic regression. Results— Significant strokextime interactions were present for all cognitive domains, with stroke cases showing a greater rate of decline compared with nonstrokes. Stroke recurrence during follow-up was responsible for significantly greater global decline. Strokes with recurrence (P=0.02), age (P=0.004), and baseline cognitive impairment (P<0.001) were independently associated with incident dementia at 2 years. Strokes without recurrence (P=0.008), age (P=0.001), and baseline cognitive impairment (P<0.001) were independently associated with CIND at 2 years. Conclusions— Recurrent stroke contributes importantly to global cognitive decline after a first-ever stroke. Secondary stroke prevention will be important in ameliorating dementia related to stroke. Mechanisms underlying the progression of early cognitive impairment to dementia in stroke patients need further investigation.

Item Type: Article
Keywords: aging • dementia • epidemiology • stroke • vascular cognitive impairment
Journal or Publication Title: Stroke
Page Range: pp. 2479-2483
ISSN: 0039-2499
Identification Number - DOI: 10.1161/01.STR.0000239666.46828.d7
Additional Information: © 2006 American Heart Association, Inc.
Date Deposited: 10 Sep 2008 01:30
Last Modified: 18 Nov 2014 03:50
URI: http://eprints.utas.edu.au/id/eprint/7532
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