Medial temporal lobe atrophy in stroke patients: relation to pre-existing dementia.
OBJECTIVE
The links between stroke and Alzheimer's disease seem to be closer than expected by chance. In a previous study it was shown that up to 16% of patients admitted for stroke had pre-existing dementia. Medial temporal lobe atrophy (MTLA) is strongly associated with Alzheimer's disease. The aim of this study was to determine the prevalence of MTLA and its relation with pre-existing dementia.


METHODS
The study was conducted on 170 consecutive stroke patients (87 women; median age 75 years; 152 infarcts), who underwent non-contrast CT with temporal lobe oriented 2 mm contiguous slices at admission. A cut off point of 11.5 mm was used to differentiate patients with and without MTLA. Pre-existing dementia was assessed using the informant questionnaire on cognitive decline in the elderly (IQCODE) with a cut off score of 104.


RESULTS
Ninety four patients (55.3%) had MTLA, of whom 23 (24.5%) had pre-existing dementia; of 76 patients without MTLA, only four (5.3%) had pre-existing dementia (p=0.0007). The logistic regression analysis with MTLA as dependent variable found the following independent variables: increasing age (p<0.05), and global cerebral atrophy scores (p<0.01). The IQCODE scores just reached significance (p=0.05).


CONCLUSIONS
Stroke patients with MTLA are more likely to have pre-existing dementia; this suggests that Alzheimer's disease might contribute to the dementia syndrome. A longitudinal follow up is now necessary to determine whether stroke patients with MTLA and without pre-existing dementia are at increased risk of Alzheimer's disease over subsequent years.
Hénon
H
H
Department of Neurology, Hôpital Roger Salengro, Lille, France.
Pasquier
F
F
Durieu
I
I
Pruvo
J P
JP
Leys
D
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000523:psychology*; D001284:Atrophy / Q000473:pathology; D002561:Cerebrovascular Disorders / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013702:Temporal Lobe / Q000473:pathology*; D013997:Time Factors