title: Stroke rehabilitation is associated with a reduction in dementia risk: a population-based retrospective cohort study.
abstract: OBJECTIVE
  Focusing on the relationship between physical activity and incident cognitive impairment, the aim of this study was to investigate whether stroke rehabilitation reduces the risk of dementia.
  
  
  METHODS
  Claims data of 1,000,000 insured subjects randomly selected from the National Health Insurance programme of Taiwan were used to identify adults with a newly diagnosed ischaemic stroke in 1997-2002. Among them, 1,375 received rehabilitation and 3,722 did not. Both groups were followed up until the end of 2007 to measure the incidence of development of dementia.
  
  
  RESULTS
  The incidence of development of dementia was lower in the rehabilitation cohort than in the non-rehabilitation cohort (1.22 vs 1.70 per 100 person-years), with an adjusted hazard ratio (HR) of 0.73 (95% confidence interval (CI) = 0.60-0.89) in the multivariate Cox proportional hazard regression analysis. Female gender (HR = 1.26, 95% CI = 1.07-1.50), older age (HR = 7.71, 95% CI = 3.36-17.7), low income (HR = 1.82, 95% CI = 1.42-2.33), and Parkinson's disease (HR = 1.64, 95% CI = 1.33-2.03) were risk factors associated with the development of dementia.
  
  
  CONCLUSIONS
  Post-stroke rehabilitation is associated with a reduction in dementia risk among ischaemic stroke patients.
authors.affiliation: Department of Physical Medicine and Rehabilitation, China Medical University Hospital, 404 Taichung, Taiwan.
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Chou
authors.forename: Chien-Chang
authors.initials: CC
authors.lastname: Liao
authors.forename: Li-Ting
authors.initials: LT
authors.lastname: Su
authors.forename: Pei-Yu
authors.initials: PY
authors.lastname: Yang
authors.forename: Fung-Chang
authors.initials: FC
authors.lastname: Sung
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000209:etiology / Q000517:prevention & control*; D016001:Confidence Intervals; D003704:Dementia / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D007182:Income; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010300:Parkinson Disease / Q000150:complications; D011203:Poverty; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult