Progressive dementia after first-ever stroke: a community-based follow-up study.
OBJECTIVE
To examine the risk and determinants of a progressive dementia syndrome and cognitive impairment not dementia (CIND) in community-based nonaphasic first-ever stroke cases 1 year after stroke, relative to a matched community-based stroke-free group.


METHODS
Matched cohort design, with cognitive tests given on two occasions 9 months apart to 99 mild-to-moderate first-ever stroke patients and 99 age- and sex-matched people without stroke. At follow-up, progressive dementia or CIND were diagnosed, with judges blinded to stroke/nonstroke status.


RESULTS
Progressive dementia was diagnosed in 12.5% of stroke patients and 15.4% of those without strokes (RR 1.1, 95% CI 0.5 to 2.2, p = 0.85). CIND was diagnosed in 37.5% of stroke patients and 17.6% of participants without strokes (RR 2.1, 95% CI 1.2 to 3.4, p = 0.003). In multivariable regression, age (p = 0.04) and baseline cognition (p < 0.001) were independently associated with dementia whereas stroke (p = 0.002), age (p = 0.05), baseline cognition (p = 0.001), and baseline mood (p = 0.03) were independently associated with CIND at follow-up.


CONCLUSIONS
In this community-based nonaphasic sample, mild-to moderate first-ever stroke was not associated with the presence of progressive dementia 1 year later, but was clearly associated with a greater risk of cognitive impairment not dementia (CIND). Baseline mood impairment remained independently associated with CIND at 1 year after taking into account stroke, age, and baseline cognitive ability.
Srikanth
V K
VK
Menzies Research Institute, Tasmania, Australia.
Anderson
J F I
JF
Donnan
G A
GA
Saling
M M
MM
Didus
E
E
Alpitsis
R
R
Dewey
H M
HM
Macdonell
R A L
RA
Thrift
A G
AG
D000368:Aged; D000369:Aged, 80 and over; D015982:Bias; D016022:Case-Control Studies; D002544:Cerebral Infarction / Q000145:classification / Q000150:complications* / Q000453:epidemiology; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology; D015331:Cohort Studies; D015897:Comorbidity; D003704:Dementia / Q000453:epidemiology* / Q000209:etiology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D018579:Patient Selection; D012307:Risk Factors; D016037:Single-Blind Method; D014481:United States / Q000453:epidemiology