Deans' stroke musings: Late-life cynical distrust, risk of incident dementia, and mortality in a population-based cohort

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.

Thursday, May 29, 2014

Late-life cynical distrust, risk of incident dementia, and mortality in a population-based cohort

Your doctor should be warning you about your cynicism in conjunction with your 33% chance of getting dementia/Alzheimers post stroke.

http://www.neurology.org/content/early/2014/05/28/WNL.0000000000000528

Elisa Neuvonen,
Minna Rusanen, MD, PhD,
Alina Solomon, MD, PhD,
Tiia Ngandu, MD, PhD,
Tiina Laatikainen, MD, PhD,
Hilkka Soininen, MD, PhD,
Miia Kivipelto, MD, PhD and
Anna-Maija Tolppanen, PhD

+Show Affiliations

Correspondence to Dr. Tolppanen: anna-maija.tolppanen@uef.fi

Published online before print May 28, 2014, doi: 10.1212/WNL.0000000000000528 Neurology 10.1212/WNL.0000000000000528

Abstract
Full Text (PDF)

Also available:
Data Supplement

Abstract

Objective: We investigated the association between late-life cynical distrust and incident dementia and mortality (mean follow-up times of 8.4 and 10.4 years, respectively) in the Cardiovascular Risk Factors, Aging and Dementia Study.

Methods: Cynical distrust was measured based on the Cook-Medley Scale and categorized into tertiles. Cognitive status was evaluated with a 3-step protocol including screening, clinical phase, and differential diagnostic phase. Dementia was diagnosed according to DSM-IV criteria. Complete data on exposure, outcome, and confounders were available from 622 persons (46 dementia cases) for the dementia analyses and from 1,146 persons (361 deaths) for the mortality analyses. Age, sex, systolic blood pressure, total cholesterol, fasting glucose, body mass index, socioeconomic background, smoking, alcohol use, self-reported health, and APOE genotype were considered as confounders.

Results: Cynical distrust was not associated with dementia in the crude analyses, but those with the highest level of cynical distrust had higher risk of dementia after adjusting for confounders (relative risk 3.13; 95% confidence interval [CI] 1.15–8.55). Higher cynical distrust was associated with higher mortality in the crude analyses (hazard ratio 1.40; 95% CI 1.05–1.87) but the association was explained by confounders (adjusted hazard ratio 1.19; 95% CI 0.86–1.61).

Conclusions: Higher cynical distrust in late life was associated with higher mortality, but this association was explained by socioeconomic position, lifestyle, and health status. Association between cynical distrust and incident dementia became evident when confounders were considered. This novel finding suggests that both psychosocial and lifestyle-related risk factors may be modifiable targets for interventions. We acknowledge the need for larger replication studies.