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Christina Lau, 21 Nov 2018

Pharmacological management of vascular cognitive impairment (VCI) is a balancing act when it comes to the use of antihypertensives, statins and oral anticoagulants (OACs), according to Professor Majon Muller of the Department of Internal Medicine, Amsterdam University Medical Center, the Netherlands, who spoke at VasCog 2018 held in Hong Kong.

Risk of dementia high before, after stroke

10 Oct 2018

The risk of dementia is elevated before and after an index stroke even in women, a recent study has found.

The study included 1,460 women (mean age 46.8±6.2 years) without stroke or dementia at baseline, and who were followed-up for 44 years. Neuropsychiatric examinations and informant interviews, as well as reviews of hospital registries and medical records, were used to identify the development of stroke or dementia.

A total of 362 participants developed first-onset stroke during 49,623 person-years of follow-up at a mean age of 77.8±8.7 years. In comparison, 325 cases of dementia were reported during 49,663 person-years at a mean age of 79.8±7.9 years. Mortality rates were 81 percent and 69 percent, respectively.

The cumulative incidence of prestroke dementia was 13.8 percent (n=50), majority of whom developed the neurological condition 5 years before the index stroke. Poststroke dementia was reported in 54 women (18.4 percent).

During 44 years of follow-up, 33.7 percent of women with a history of stroke developed dementia. This was significantly higher than in those without such history (18.5 percent; age-adjusted hazard ratio [HR] without competing risk, 1.44; 95 percent CI, 1.14–1.81). The age of dementia onset was similar in both groups (78.9±6.8 vs 77.3±7.8 years).

Notably, the increase in age-adjusted dementia risk achieved significance 5 years before the index stroke event (HR, 1.57; 1.03–2.40) and gradually increased to stroke onset (1 year before: HR, 2.65; 1.48–4.75; the same year: HR, 3.85; 2.37–6.26), reaching its peak during the year after stroke (HR, 4.17; 2.46–7.07).

The associated dementia risk remained significant 2–5 years after stroke event (HR, 1.78; 1.08–2.94).

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Most Read Articles
Christina Lau, 21 Nov 2018

Pharmacological management of vascular cognitive impairment (VCI) is a balancing act when it comes to the use of antihypertensives, statins and oral anticoagulants (OACs), according to Professor Majon Muller of the Department of Internal Medicine, Amsterdam University Medical Center, the Netherlands, who spoke at VasCog 2018 held in Hong Kong.