Prestroke dementia.
OBJECTIVE
To determine the frequency, associated factors and outcome of dementia previous to a stroke.


METHODS
Cross-sectional study of a cohort of 324 consecutive unselected stroke patients (mean age 70.9 years, range 20-98; 255 ischaemic, 46 haemorrhagic and 25 indefinite).


METHODS
Cognitive and functional status prior to stroke were assessed by means of an interview to a relative, a short version of the Informant Questionnaire on Cognitive Decline in the Elderly and the Barthel Index. The DSM-III-R criteria were used to establish the diagnosis of prestroke dementia. Clinical and CT features of patients with and without prestroke dementia were compared.


RESULTS
Forty-nine patients (15%) were demented before stroke; they were significantly older, less well educated, they had more frequently female gender, prior cerebrovascular disease, cerebral and medial temporal lobe atrophy and leukoaraiosis in the CT scan, and they had a higher mortality rate. Female sex (OR 3.7, CI 95% 1.2-12), low education (OR 2.1, CI 95% 1.1-4.2), previous stroke (OR 3.6, CI 95% 1.2-11), and cerebral atrophy (OR 3.8, CI 95% 1.7-8.3) were independently associated with prestroke dementia in the logistic regression analysis.


CONCLUSIONS
Fifteen percent of stroke patients have prestroke dementia and they have a worse outcome. Factors associated with prestroke dementia are reminiscent both of degenerative and vascular brain pathology.
Barba
R
R
Servicio de Medicina Interna, Hospital de Alcorcón, Madrid, Spain.
Castro
M D
MD
del Mar Morín
M
M
Rodriguez-Romero
R
R
Rodríguez-García
E
E
Cantón
R
R
Del Ser
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy; D001921:Brain / Q000473:pathology; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003071:Cognition; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D015140:Dementia, Vascular / Q000150:complications* / Q000401:mortality / Q000503:physiopathology / Q000523:psychology; D004522:Educational Status; D004827:Epilepsy / Q000453:epidemiology; D005190:Family; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D013030:Spain; D020521:Stroke / Q000401:mortality / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy*; D015996:Survival Rate; D044465:White People