Depression, Type 2 Diabetes, and Poststroke Cognitive Impairment

Well, if we had a great stroke association we would know exactly how common dementia is after stroke and how to prevent it. Because we don't you'll just have to flail on your own.
1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.
2. Then this study came out and seems to have a range from 17-66%. December 2013.
3. A 20% chance in this research.   July 2013.
If you have anything close to a decent doctor a protocol will already be in place to prevent this from occurring. 
http://nnr.sagepub.com/content/early/2016/06/29/1545968316656054.abstract

1. Walter Swardfager, PhD1,2,3⇑
2. Bradley J. MacIntosh, PhD1,2

1. ¹Sunnybrook Research Institute, Toronto, Ontario, Canada
2. ²University of Toronto, Toronto, Ontario, Canada
3. ³University Health Network Toronto Rehabilitation Institute, Toronto, Ontario, Canada

1. Walter Swardfager, Department of Pharmacology & Toxicology, University of Toronto, 1 King’s College Circle, Toronto, Ontario, M5S 1A8, Canada. Email: w.swardfager@utoronto.ca

Abstract

Background. Ten percent of stroke survivors develop dementia, which increases to more than a third after recurrent stroke. Other survivors develop less severe vascular cognitive impairment. In the general population, depression, and diabetes interact in predicting dementia risk, and they are both prevalent in stroke. Objective. To assess the cumulative association of comorbid depressive symptoms and type 2 diabetes with cognitive outcomes among stroke survivors. Methods. Multicenter observational cohort study of people within 6 months of stroke. Depression and cognitive status were screened using the Center for Epidemiological Studies Depression (CES-D) scale and the Montreal Cognitive Assessment (MoCA), respectively. Processing speed, executive function and memory were assessed using the Trail Making Test parts A and B, and the 5 Word Delayed Free Recall task. Results. Among 342 participants (age 67.0 ± 13.5 years, 43.3% female, 46 ± 35 days poststroke), the prevalence of type 2 diabetes was 32.2% and depressive symptoms (CES-D ≥16) were found in 40.6%. Diabetes and depressive symptoms increased the risk of severe cognitive impairment (MoCA <20) with adjusted odds ratio (OR) 2.12 (95% confidence interval [CI] 1.20-3.74, P = .010) for 1 comorbidity and OR 3.18 (95% CI 1.26-8.02, P = .014) for both comorbidities. Associated cognitive deficits included executive function (F_{1, 168} = 3.43, P = .035) but not processing speed (F_{1, 168} = 1.86, P = .16) or memory (F_{1, 168} = 0.82, P = .44). Conclusions. Diabetes and depressive symptoms were associated cumulatively with poorer cognitive screening outcomes poststroke, particularly deficits in executive function. Having 1 comorbidity doubled the odds of screening for severe cognitive impairment, having both tripled the odds.