Incidence and determinants of poststroke dementia as defined by an informant interview method in a hospital-based stroke registry.
OBJECTIVE
Inconsistent information about incidence and determinants of poststroke dementia might be related to patient attrition, partly because of nonapplicability of formal neuropsychological testing to a large proportion of patients registered in a definite setting.


METHODS
Using a proxy-informant interview based on ICD-10 criteria, we determined dementia at stroke onset and 1 year after stroke in the 339 patients who survived, were available for follow-up, and were not demented at stroke onset of 635 patients entered over a 1-year period in a stroke registry taken at 2 community hospitals in Florence, Italy.


RESULTS
Of the 339 patients, 57 (16.8%) proved to have poststroke dementia. These patients were older, more frequently female, and more often (multivariate odds ratio, 2.35; 95% CI, 1.21 to 4.58) had atrial fibrillation than those without dementia. Aphasia and the clinical features expressing the severity of the stroke event in the acute phase predicted poststroke dementia.


CONCLUSIONS
In a hospital-based nonselected series of stroke survivors, despite the use of a method with low sensitivity for defining dementia, our study confirms that dementia is a frequent sequela of stroke and is mainly predicted by stroke severity. Certain determinants could be controlled in the prestroke phase, thus reducing its risk.
Inzitari
D
D
Department of Neurological and Psychiatric Sciences, University of Florence, Italy.
Di Carlo
A
A
Pracucci
G
G
Lamassa
M
M
Vanni
P
P
Romanelli
M
M
Spolveri
S
S
Adriani
P
P
Meucci
I
I
Landini
G
G
Ghetti
A
A
D017677:Age Distribution; D000368:Aged; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000503:physiopathology; D003704:Dementia / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D005544:Forecasting; D006764:Hospitals, Community; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D007558:Italy; D008297:Male; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D017678:Sex Distribution