Prestroke dementia in patients with atrial fibrillation. Frequency and associated factors.
OBJECTIVE
Prestroke dementia is frequent but usually not identified. Non-valvular atrial fibrillation (NVAF) is independently associated with an increased risk for dementia. However, the frequency and determinants of prestroke dementia in patients with NVAF have never been evaluated.


OBJECTIVE
The aim of this study was to determine the frequency of prestroke dementia and associated factors in patients with a previously known NVAF.


METHODS
This is an ancillary study of Stroke in Atrial Fibrillation Ensemble II (SAFE II), an observational study conducted in patients with a previously known NVAF, consecutively admitted for an acute stroke in French and Italian centers. Prestroke dementia was evaluated by the IQCODE in patients with a reliable informant. Patients were considered as demented before stroke when their IQCODE score was > or = 104.


RESULTS
of 204 patients, 39 (19.1%; 95% confidence interval [CI]: 13.7%-24.5%) patients met criteria for prestroke dementia. The only variable independently associated with prestroke dementia was increasing age (adjusted odds ratio for 1 year increase in age: 1.10; 95 % CI: 1.04-1.17), and there was a nonsignificant tendency for previous ischemic stroke or TIA and arterial hypertension.


CONCLUSIONS
One fifth of stroke patients with a previously known NVAF were already demented before stroke. The main determinant of prestroke dementia is increasing age. A large cohort is necessary to identify other determinants.
Lefebvre
C
C
Dept. of Neurology, University of Lille, Roger Salengro Hospital, 59037 Lille, France.
Deplanque
D
D
Touzé
E
E
Hénon
H
H
Parnetti
L
L
Pasquier
F
F
Gallai
V
V
Leys
D
D
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications* / Q000453:epidemiology*; D016001:Confidence Intervals; D015140:Dementia, Vascular / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019370:Observation; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology*