title: One-year survival of demented stroke patients: data from the Dijon Stroke Registry, France (1985-2008).
abstract: OBJECTIVE
  Dementia is a frequent condition after stroke that may affect the prognosis of patients. Our aim was to determine whether post-stroke dementia was a predictor of 1-year case-fatality and to evaluate factors that could influence survival in demented stroke patients.
  
  
  METHODS
  From 1985 to 2008, all first-ever strokes were recorded in the population-based stroke registry of Dijon, France (150, 000 inhabitants). Dementia was diagnosed during the first month following stroke, according to DSM-III and DSM-IV criteria. Survival was evaluated at 1 year and multivariate analyses were performed using Cox proportional hazards to identify independent predictive factors.
  
  
  RESULTS
  We recorded 3948 first-ever strokes. Among these stroke patients, 3201 (81%) were testable, and of these, 653 (20.4%) had post-stroke dementia (337 women and 316 men). Demented patients had lower 1-year survival than patients without dementia (82.9% vs. 86.9%, P = 0.013). However, in multivariate analysis, dementia did not appear as an independent predictor of 1-year death. In demented stroke patients, age >80 years old, severe handicap at discharge, recurrent stroke within the first year and subarachnoid haemorrhage were associated with a higher risk of 1-year death, and the risk was lower in the study period 2003-2008.
  
  
  CONCLUSIONS
  Dementia after stroke is not independently associated with an increased risk of death at 1 year. In recent years, 1-year case-fatality decreased in demented as well as in and non-demented patients suggesting that improvements in the management of stroke also benefited the most fragile patients.
authors.affiliation: Faculty of Medicine, University of Burgundy, France. ybejot@yahoo.fr
authors.forename: Y
authors.initials: Y
authors.lastname: Béjot
authors.forename: A
authors.initials: A
authors.lastname: Jacquin
authors.forename: O
authors.initials: O
authors.lastname: Rouaud
authors.forename: J
authors.initials: J
authors.lastname: Durier
authors.forename: C
authors.initials: C
authors.lastname: Aboa-Eboulé
authors.forename: M
authors.initials: M
authors.lastname: Hervieu
authors.forename: G-V
authors.initials: GV
authors.lastname: Osseby
authors.forename: M
authors.initials: M
authors.lastname: Giroud
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003704:Dementia / Q000453:epidemiology* / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012042:Registries / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000453:epidemiology* / Q000401:mortality*; D015996:Survival Rate; D013997:Time Factors