Long-term cognitive transitions, rates of cognitive change, and predictors of incident dementia in a population-based first-ever stroke cohort
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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Official URL: http://dx.doi.org/10.1161/01.STR.0000239666.46828.d7
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.
|Additional Information:||© 2006 American Heart Association, Inc.|
|Keywords:||aging • dementia • epidemiology • stroke • vascular cognitive impairment|
|Deposited By:||Ms Emma Stubbs|
|Deposited On:||10 Sep 2008 11:30|
|Last Modified:||24 Feb 2009 09:36|
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