The combined effect of age, education, and stroke on dementia and cognitive impairment no dementia in the elderly.
BACKGROUND
This study aims to detect the impact of stroke on the occurrence of dementia and cognitive impairment/no dementia (CIND) in different age, sex, and education groups.


METHODS
Persons with dementia (DSM-III-R) or CIND were identified by a two-phase study design among 7,930 persons from the population-based Faenza Community Aging Study.


RESULTS
Subjects with a history of stroke had increased risk of both dementia [risk ratio (RR) = 3.7; 95% confidence interval (CI) = 3.1-4.4] and CIND (RR = 1.7, 95% CI = 1.4-2.2). These associations were stronger in the younger-old (61-74 years) than in the older-old (75+ years), and among higher-educated (4+ years) than lower-educated (0-3 years of schooling) persons. Dementia and CIND prevalence among stroke subjects was similar to the prevalence detected among subjects 10 years older but without a history of stroke. In stroke subjects, dementia prevalence became higher than CIND prevalence 10 years earlier than in non-stroke subjects. A combined effect for dementia due to a history of stroke, increasing age, and decreasing years of schooling was detected.


CONCLUSIONS
Stroke is a strong risk factor for dementia among younger-old and higher-educated subjects; in the presence of a stroke, dementia onset might occur about 10 years earlier, possibly by accelerating the progression from CIND to dementia.
De Ronchi
Diana
D
Aging Research Center, Karolinska Institutet, Stockholm, Sweden.
Palmer
Katie
K
Pioggiosi
Philippe
P
Atti
Anna Rita
AR
Berardi
Domenico
D
Ferrari
Barbara
B
Dalmonte
Edoardo
E
Fratiglioni
Laura
L
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D003704:Dementia / Q000453:epidemiology / Q000209:etiology*; D018450:Disease Progression; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment; D020521:Stroke / Q000523:psychology*