Stroke, Vol 21, 858-866, Copyright © 1990 by American Heart Association
TK Tatemichi, MA Foulkes, JP Mohr, JR Hewitt, DB Hier, TR Price and PA Wolf
We determined the prevalence of dementia in 927 patients with acute
ischemic stroke aged greater than or equal to 60 years in the Stroke Data
Bank cohort based on the examining neurologist's best judgment. Diagnostic
agreement among examiners was 68% (kappa = 0.34). Of 726 testable patients,
116 (16%) were demented. Prevalence of dementia was related to age but not
to sex, race, handedness, educational level, or employment status before
the stroke. Previous stroke and previous myocardial infarction were related
to prevalence of dementia although hypertension, diabetes mellitus, atrial
fibrillation, and previous use of antithrombotic drugs were not. Prevalence
of dementia was most frequent in patients with infarcts due to large-artery
atherosclerosis and in those with infarcts of unknown cause. Computed
tomographic findings related to prevalence of dementia included infarct
number, infarct site, and cortical atrophy. Among 610 patients who were not
demented at stroke onset, we used methods of survival analysis to determine
the incidence of dementia occurring during the 2-year follow- up. Incidence
of dementia was related to age but not sex. Based on logistic regression
analysis, the probability of new-onset dementia at 1 year was 5.4% for a
patient aged 60 years and 10.4% for a patient aged 90 years. With a
multivariate proportional hazards model, the most important predictors of
incidence of dementia were a previous stroke and the presence of cortical
atrophy at stroke onset.
ARTICLES
Dementia in stroke survivors in the Stroke Data Bank cohort. Prevalence, incidence, risk factors, and computed tomographic findings
Department of Neurology, Columbia-Presbyterian Medical Center, New York, New York.
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