Deans' stroke musings: Does the Influence of Stroke on Dementia Vary by Different Levels of Prestroke Cognitive Functioning?

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, November 25, 2013

Does the Influence of Stroke on Dementia Vary by Different Levels of Prestroke Cognitive Functioning?

I'm really going to have to work on my dementia prevention. Damn I shouldn't have been so smart prior to this shitworthy stroke.

Does the Influence of Stroke on Dementia Vary by Different Levels of Prestroke Cognitive Functioning?

A Cohort Study

+ Author Affiliations

From the Department of Primary Care and Public Health Sciences, King’s College London, NIHR Biomedical Research Centre, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom.

Correspondence to Alex Dregan, PhD, Department of Primary Care and Public Health, King’s College London, NIHR Biomedical Research Centre, Guy’s and St Thomas’ NHS Foundation Trust, 6th Floor, Capital House, 42 Weston St, London SE1 3QD, United Kingdom. E-mail alexandru.dregan@kcl.ac.uk

Abstract

Background and Purpose—The association between stroke and subsequent dementia or Alzheimer disease is well established. What is less understood is the extent to which this association is dependent on prestroke cognitive functioning. The study estimated the occurrence in poststroke dementia as a function of prestroke cognitive status and incident stroke.

Methods—Study data were derived from the English Longitudinal Study of Ageing, a 10-year long prospective cohort study of older adults living in England. Baseline data (2002/2003) were used to group participants into tertiles of cognitive, memory, and executive functioning before an incident stroke. Data from 4 follow-up surveys were used to identify new stroke and poststroke dementia events.

Results—The analyses were based on 10 809 participants aged ≥50 years at baseline. High prestroke executive functioning was associated with lower relative risk (RR) of dementia (RR, 0.24; 95% confidence interval, 0.13–0.45; P<0.001). Stroke was associated with increased RR of poststroke dementia (RR, 2.63; 95% confidence interval, 1.80–3.84; P<0.001). The association of stroke with poststroke dementia was greater for participants with higher prestroke executive functioning (interaction term RR, 4.4; 95% confidence interval, 1.35–14.63; P=0.014). For participants with higher executive functioning, the probability of dementia was 0.3% without stroke and 3.1% after stroke, compared with 1.9% and 5.2% for lower executive functioning.

Conclusions—Stroke and prestroke cognition were independently associated with increased probability of poststroke dementia. Stroke results in disproportionate increase in the risk of dementia when premorbid cognitive functioning is high.