Dementia Among Patients with Ischemic Stroke in Maharaj Nakorn Chiang Mai Hospital: Prevalence and Its Associating Factors
Keywords:
Cognitive impairment, dementia, stroke, vascular dementia, neuropsychological assessmentAbstract
Objective: To study the prevalence of dementia and related cognitive disorders in patients with stroke followed up at internal medicine and neurology outpatient clinics and to study its associating factors. Materials and Methods: The retrospective cross sectional cohort study was conducted in 98 patients with ischemic stroke, which has undergone cognitive assessments via Mini-mental status examination: Thai version (MMSE – Thai 2002) and Montreal cognitive assessment (MoCA). The diagnosis of cognitive disorders was based on these neuropsychological scores. Results: In 98 patients with ischemic stroke studied, the overall prevalence of vascular dementia (VAD) was 30.61%. Dementia was significant was associated with older patients (OR=1.06; 95%CI, 1.02-1.11; P<0.01) and hypertension (OR=3.55; 95%CI, 1.11-11.36; P=0.03). In the multivariate analysis, hypertension was not statistically significant (adjusted for age) (OR=2.64; 95%CI, 0.78-8.88; P=0.12). Conclusion: The prevalence of dementia in internal medicine and neurology outpatient clinic was about one-third. There is no statistically significant difference in clinical and neuroimaging characteristics between stroke patients with and without dementia, which should be further studied.
References
Rockwood K, Stadnyk K. The prevalence of dementia in the elderly: a review. Canadian journal of psychiatry Revue canadienne de psychiatrie 1994;39:253-7.
Canadian study of health and aging: study methods and prevalence of dementia. CMAJ 1994;150:899-913.
Graham JE, Rockwood K, Beattie BL, et al. Prevalence and severity of cognitive impairment with and without dementia in an elderly population. Lancet 1997;349:1793-6.
Moorhouse P, Rockwood K. Vascular cognitive impairment: current concepts and clinical developments. Lancet Neurol 2008;7:246-55.
Tatemichi TK, Paik M, Bagiella E, Desmond DW, Pirro M, Hanzawa LK. Dementia after stroke is a predictor of long-term survival. Stroke 1994;25:1915-9.
Desmond DW, Moroney JT, Paik MC, et al. Frequency and clinical determinants of dementia after ischemic stroke. Neurology 2000;54:1124-31.
Pohjasvaara T, Erkinjuntti T, Vataja R, Kaste M. Dementia three months after stroke. Baseline frequency and effect of different definitions of dementia in the Helsinki Stroke Aging Memory Study (SAM) cohort. Stroke 1997;28:785-92.
Madureira S, Guerreiro M, Ferro JM. Dementia and cognitive impairment three months after stroke. Eur J Neurol 2001;8: 621-7.
Tham W, Auchus AP, Thong M, et al. Progression of cognitive impairment after stroke: one year results from a longitudinal study of Singaporean stroke patients. J Neurol Sci 2002;203-204:49-52.
Patel M, Coshall C, Rudd AG, Wolfe CD. Natural history of cognitive impairment after stroke and factors associated with its recovery. Clinical rehabilitation 2003;17:158-66.
Sachdev PS, Brodaty H, Valenzuela MJ, et al. Clinical determinants of dementia and mild cognitive impairment following ischaemic stroke: the Sydney Stroke Study. Dementia and geriatric cognitive disorders 2006;21: 275-83.
Ihle-Hansen H, Thommessen B, Wyller TB, et al. Incidence and subtypes of MCI and dementia 1 year after first-ever stroke in patients without pre-existing cognitive impairment. Dementia and geriatric cognitive disorders 2011;32:401-7.
Jacquin A, Binquet C, Rouaud O, et al. Poststroke cognitive impairment: high prevalence and determining factors in a cohort of mild stroke. Journal of Alzheimer’s disease : JAD 2014;40:1029-38.
Censori B, Manara O, Agostinis C, et al. Dementia after first stroke. Stroke 1996;27: 1205-10.
Ballard C, Stephens S, Kenny R, Kalaria R, Tovee M, O’Brien J. Profile of neuropsychological deficits in older stroke survivors without dementia. Dementia and geriatric cognitive disorders 2003;16:52-6.
Bowler JV, Hadar U, Wade JP. Cognition in stroke. Acta Neurol Scand 1994;90:424-9.
Kokmen E, Whisnant JP, O’Fallon WM, Chu CP, Beard CM. Dementia after ischemic stroke: a population-based study in Rochester, Minnesota (1960-1984). Neurology 1996;46: 154-9.
Nys GM, Van Zandvoort MJ, De Kort PL, et al. Domain-specific cognitive recovery after first-ever stroke: a follow-up study of 111 cases. Journal of the International Neuropsychological Society : JINS 2005;11:795-806.
Duron E, Hanon O. Hypertension, cognitive decline and dementia. Archives of cardiovascular diseases 2008;101:181-9.
Boonkerd P, Assantachai P, Senanarong W. Clinical practice guideline for dementia (in Thai). Bangkok: Neuroscience Institute; 2003.
Montreal Cognitive Assessment (MOCA) (Thai translation) 2011. Available from: http://www.mocatest.org/wp-content/uploads/2015/tests-instructions/MoCA-Test-Thai.pdf.
Lawton MP, Brody EM: Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969, 9: 179-186.
Budson AE, Solomon PR. New diagnostic criteria for Alzheimer’s disease and mild cognitive impairment for the practical neurologist. Practical neurology 2012;12:88-96.
Roman GC, Tatemichi TK, Erkinjuntti T, et al. Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology 1993;43:250-60.
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