Deans' stroke musings: Incidence of Dementia After Ischemic Stroke Results of a Longitudinal Study

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.

Tuesday, August 16, 2016

Incidence of Dementia After Ischemic Stroke Results of a Longitudinal Study

This has been out since 2002. Has your doctor or stroke hospital done one damn thing to prevent this from happening?
http://stroke.ahajournals.org/content/33/9/2254

David W. Desmond, PhD;
Joan T. Moroney, MD, MRCPI;
Mary Sano, PhD;
Yaakov Stern, PhD

+ Author Affiliations

From the Departments of Neurology and Pathology, SUNY Downstate Medical Center, Brooklyn, NY (D.W.D.); Department of Clinical Neurosciences, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland (J.T.M.); and Departments of Neurology and Psychiatry and the Gertrude H. Sergievsky Center, Columbia University, College of Physicians and Surgeons, New York, NY (M.S., Y.S.).

Correspondence to Dr David W. Desmond, SUNY Downstate Medical Center, 450 Clarkson Ave, Box 25, Brooklyn, NY 11203. E-mail dwdesmond@usa.net

Abstract

Background and Purpose— A number of cross-sectional epidemiological studies have reported that one fourth of elderly patients meet criteria for dementia 3 months after ischemic stroke, but few longitudinal studies of the incidence of dementia after stroke have been performed. We conducted the present study to investigate the incidence and clinical predictors of dementia after ischemic stroke.

Methods— We administered neurological, neuropsychological, and functional assessments annually to 334 ischemic stroke patients (age, 70.4±7.5 years) and 241 stroke-free control subjects (age, 70.6±6.5 years), all of whom were nondemented in baseline examinations. We diagnosed incident dementia using modified Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition criteria requiring deficits in memory and ≥2 additional cognitive domains, as well as functional impairment.

Results— The crude incidence rate of dementia was 8.49 cases per 100 person-years in the stroke cohort and 1.37 cases per 100 person-years in the control cohort. A Cox proportional-hazards analysis found that the relative risk (RR) of incident dementia associated with stroke was 3.83 (95% CI, 2.14 to 6.84), adjusting for demographic variables and baseline Mini-Mental State Examination score. Within the stroke cohort, intercurrent medical illnesses associated with cerebral hypoxia or ischemia were independently related to incident dementia (RR, 4.40; 95% CI, 2.20 to 8.85), adjusting for recurrent stroke, demographic variables, and baseline Mini-Mental State Examination score.

Conclusions— The risk of incident dementia is high among patients with ischemic stroke, particularly in association with intercurrent medical illnesses that might cause cerebral hypoxia or ischemia, suggesting that cerebral hypoperfusion may serve as a basis for some cases of dementia after stroke.