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Long-term cognitive transitions, rates of cognitive change, and predictors of incident dementia in a population-based first-ever stroke cohort

Citation

Srikanth, V and Quinn, SJ and Donnan, G and Saling, M and Thrift, A, Long-term cognitive transitions, rates of cognitive change, and predictors of incident dementia in a population-based first-ever stroke cohort, Stroke, 37, (10) pp. 2479-2483. ISSN 0039-2499 (2006) [Refereed Article]

DOI: doi:10.1161/01.STR.0000239666.46828.d7

Abstract

BACKGROUND AND PURPOSE - There are few data on long-term cognitive outcomes after first-ever stroke. We aimed to study long-term cognitive transitions, rates of cognitive change, and factors associated with incident dementia and cognitive impairment-no dementia (CIND) 2 years after first-ever stroke. METHODS - A population-based cohort of incident first-ever stroke cases (n=99; mean age, 69.9 years) and an age- and sex-matched comparison group (nonstrokes, n=99) were followed up for 2 years by 3 serial examinations. Rates of cognitive change were compared by repeated-measures analyses. Factors associated with incident dementia and CIND at 2 years were determined by multinomial logistic regression. RESULTS - Significant stroke×time interactions were present for all cognitive domains, with stroke cases showing a greater rate of decline compared with nonstrokes. Stroke recurrence during follow-up was responsible for significantly greater global decline. Strokes with recurrence (P=0.02), age (P=0.004), and baseline cognitive impairment (P<0.001) were independently associated with incident dementia at 2 years. Strokes without recurrence (P=0.008), age (P=0.001), and baseline cognitive impairment (P<0.001) were independently associated with CIND at 2 years. CONCLUSIONS - Recurrent stroke contributes importantly to global cognitive decline after a first-ever stroke. Secondary stroke prevention will be important in ameliorating dementia related to stroke. Mechanisms underlying the progression of early cognitive impairment to dementia in stroke patients need further investigation. © 2006 American Heart Association, Inc.

Item Details

Item Type:Refereed Article
Research Division:Medical and Health Sciences
Research Group:Clinical Sciences
Research Field:Geriatrics and Gerontology
Objective Division:Health
Objective Group:Specific Population Health (excl. Indigenous Health)
Objective Field:Health Related to Ageing
Author:Srikanth, V (Dr Velandai Srikanth)
Author:Quinn, SJ (Dr Stephen Quinn)
ID Code:43278
Year Published:2006
Web of Science® Times Cited:55
Deposited By:Menzies Institute for Medical Research
Deposited On:2006-08-01
Last Modified:2009-10-06
Downloads:0

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