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(Stroke. 1998;29:2087-2093.)
© 1998 American Heart Association, Inc.

Original Contributions

Incidence and Determinants of Poststroke Dementia as Defined by an Informant Interview Method in a Hospital-Based Stroke Registry

Domenico Inzitari, MD; Antonio Di Carlo, MD; Giovanni Pracucci, MD; Maria Lamassa, MD; Paola Vanni, MD; Marco Romanelli, MD; Stefano Spolveri, MD; Paolo Adriani, MD; Ilaria Meucci, MD; Giancarlo Landini, MD; Augusto Ghetti, MD; for the participants in the European Community Project Florence Stroke Registry

From the Department of Neurological and Psychiatric Sciences, University of Florence (D.I., G.P., M.L., P.V., M.R.); National Research Council of Italy, Progetto Finalizzato Invecchiamento (A. Di C.); and Health Area 10 (S.S., P.A., I.M., G.L., A.G.), Florence, Italy.

Background and Purpose—Inconsistent information about incidence and determinants of poststroke dementia might be related to patient attrition, partly because of nonapplicability of formal neuropsychological testing to a large proportion of patients registered in a definite setting.

Methods—Using a proxy-informant interview based on ICD-10 criteria, we determined dementia at stroke onset and 1 year after stroke in the 339 patients who survived, were available for follow-up, and were not demented at stroke onset of 635 patients entered over a 1-year period in a stroke registry taken at 2 community hospitals in Florence, Italy.

Results—Of the 339 patients, 57 (16.8%) proved to have poststroke dementia. These patients were older, more frequently female, and more often (multivariate odds ratio, 2.35; 95% CI, 1.21 to 4.58) had atrial fibrillation than those without dementia. Aphasia and the clinical features expressing the severity of the stroke event in the acute phase predicted poststroke dementia.

Conclusions—In a hospital-based nonselected series of stroke survivors, despite the use of a method with low sensitivity for defining dementia, our study confirms that dementia is a frequent sequela of stroke and is mainly predicted by stroke severity. Certain determinants could be controlled in the prestroke phase, thus reducing its risk.

Key Words: dementia • incidence • risk factors • stroke outcome

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