Incidence and subtypes of MCI and dementia 1 year after first-ever stroke in patients without pre-existing cognitive impairment.
BACKGROUND
Post-stroke dementia is defined as any dementia occurring after stroke, and includes vascular, degenerative and mixed dementia. The aim of this study was to assess the incidence of dementia and mild cognitive impairment (MCI) one year after stroke in a population free from pre-stroke cognitive decline, and to investigate the different aetiological subtypes of post-stroke dementia and MCI, using a novel method of subclassification in order to separate vascular causes of MCI or dementia from a neurodegenerative disease.


METHODS
All patients with a first-ever stroke and TIA admitted to the stroke unit of Asker and Bærum Hospital were invited. After 12 months, dementia and MCI were diagnosed. Sub-classification was made using MRI findings, the results of biomarkers in cerebrospinal fluid and the patients' clinical cognitive profile.


RESULTS
36 (19.6%) patients developed dementia during the first year after stroke and 69 (37.5%) developed MCI. Fourteen (13.3%) were diagnosed as suffering from degenerative cognitive disease, 34 (32.4%) from vascular cognitive disease, and 57 (54.3%) from mixed disease.


CONCLUSIONS
Fifty-seven percent suffered from cognitive impairment one year after stroke and only one third from isolated vascular cognitive disease. Post-stroke cognitive impairment is complex with a high coexistence of vascular and degenerative changes.
Department of Geriatric Medicine, Asker and Bærum Hospital, Vestre Viken Hospital Trust, Rud, Norway. hege.ihle-hansen@vestreviken.no
Hege
H
Ihle-Hansen
Bente
B
Thommessen
Torgeir Bruun
TB
Wyller
Knut
K
Engedal
Anne Rita
AR
Øksengård
Vidar
V
Stenset
Kirsti
K
Løken
Morten
M
Aaberg
Brynjar
B
Fure
D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology; D002561:Cerebrovascular Disorders / Q000453:epidemiology* / Q000473:pathology; D060825:Cognitive Dysfunction / Q000145:classification / Q000453:epidemiology* / Q000473:pathology; D015897:Comorbidity; D003704:Dementia / Q000145:classification / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D002546:Ischemic Attack, Transient / Q000453:epidemiology / Q000473:pathology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000453:epidemiology* / Q000473:pathology