The following is a summary of “Magnitude and Time-Course of Dementia Risk in Stroke Survivors: A Population-Wide Matched Cohort Study,” published in the December 2024 issue of Neurology by Joundi et al.
Researchers conducted a retrospective study to assess the risk of dementia after stroke in a large cohort of people living with stroke.
They analyzed data from over 15 million people in Ontario, Canada (2002–2022) using linked administrative databases. Adults who were hospitalized for ischemic stroke, intracerebral hemorrhage, or acute myocardial infarction (AMI) were identified. People who survived a stroke were matched 1:1 to Ontario residents without stroke and to those who experienced AMI based on age, sex, rural residence, neighborhood deprivation, and vascular comorbidities. The incidence rate of dementia per 100 person-years and HRs for dementia were calculated at various time points (90 days, 1 year, 5 years, and 10 years after stroke). Sensitivity analyses adjusted for recurrent stroke and healthcare encounters.
The results showed 32,621 (18.7%) people who survived a stroke were diagnosed with dementia, compared to 21,929 (12.5%) in the reference population. The rate of dementia per 100 person-years was higher for people who survived a stroke (3.34) compared to the reference population (1.89) and the cohort of AMI (3.19 vs. 1.75). The HR for dementia was higher in people who survived a stroke (1.76; 95% CI, 1.73–1.79) compared to the reference population and the AMI (1.82; 95% CI, 1.79–1.85). The HRs showed more than a 2.5-fold increase in dementia risk within the first year, decreasing to 1.5-fold at 5 years and 1.3-fold at 20 years. Recurrent stroke was associated with a 3-fold increased dementia risk.
They concluded that people who survive a stroke face a significantly higher risk of developing dementia, highlighting the need for targeted prevention strategies.
Source: neurology.org/doi/10.1212/WNL.0000000000210131
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