Deans' stroke musings: Risk of dementia 3x higher after stroke at 1 year, elevated up to 20 years

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.

Friday, February 9, 2024

Risk of dementia 3x higher after stroke at 1 year, elevated up to 20 years

Well, I'm going on 18 years now and there is no way I'm getting dementia in the next two years. But then I luckily had mine at age 50.

Risk of dementia 3x higher after stroke at 1 year, elevated up to 20 years

Key takeaways:

Rate of dementia was highest after acute stroke compared with the general population and patients with acute myocardial infarction.
Dementia risk fell to 1.5-fold after 5 years.

For those with either acute ischemic stroke or intracerebral hemorrhage, risk of dementia was three times higher after the first year and remained elevated as many as 20 years after, a speaker said at the International Stroke Conference.

“People with acute stroke are at high risk of dementia,” Raed A. Joundi, MD, lead study author and assistant professor of medicine at McMaster University, and colleagues wrote. “Population-wide data on the risk and time-course of dementia after stroke are lacking.”

Dementia_241431741 — According to recent research, the risk of dementia is 3 times higher after sustaining a stroke at 1 year and the risk remained elevated up to 20 years. Image: Adobe Stock

To address this data gap, Joundi and colleagues conducted a population-wide analysis of more than 15 million people in Ontario, Canada, between 2002 and 2022 via linked administrative databases. They identified 180,940 individuals who were 90-day survivors of an initial acute ischemic stroke or intracerebral hemorrhage (ICH) and compared them with healthy controls in the general population, as well as those with acute myocardial infarction (AMI), matched 1:1 based on age, sex, rural residence, neighborhood marginalization and vascular comorbidities.

Joundi and colleagues employed a validated definition that included hospitalization, physician claims and medications to calculate cause-specific hazard ratios overall and across all follow-up intervals to evaluate the rate of dementia per 100 person-years.

A total of 33,765 (18.7%) individuals developed dementia over a mean follow-up of 5.5 years.

Dementia risk was elevated approximately threefold in the first year after incident stroke, decreasing to 1.5-fold by 5 years and remaining elevated 20 years later, the researchers wrote.

The researchers also found the rate of dementia per 100 person-years was highest after acute stroke compared with the general population (3.40 vs. 1.88) as well as those with AMI (3.23 vs. 1.81), with overall risk of dementia higher in those with acute stroke compared with the general population (HR = 1.79, 95% CI: 1.76-1.82) and particularly after ICH (HR = 2.43, 2.31-2.57). Similar results were observed in comparison with AMI (HR = 1.77, 1.74-1.8).

“We found that the rate of post-stroke dementia was higher than the rate of recurrent stroke over the same time period,” Joundi said in the release. “Stroke injures the brain including areas critical for cognitive function, which can impact day-to-day functioning.”

Reference:

Risk of dementia was nearly three times higher the first year after a stroke. https://newsroom.heart.org/news/risk-of-dementia-was-nearly-three-times-higher-the-first-year-after-a-stroke?preview=930e&preview_mode=True. Published Feb. 1, 2024. Accessed Feb. 6, 2024.

Sources/Disclosures

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Source:

Joundi RA, et al. Abstract 67. Risk and time-course of post-stroke dementia: A population-wide cohort study, 2002-2022. Presented at: International Stroke Conference; Feb. 7-9, 2024; Phoenix.