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ASA: Nearly One in Five People Develop Dementia After Stroke

In the first year after stroke, there is an almost threefold higher risk for dementia

By Lori Solomon HealthDay Reporter

THURSDAY, Feb. 8, 2024 (HealthDay News) — Almost one-fifth of people develop dementia after stroke, according to a study presented at the American Stroke Association International Stroke Conference 2024, held from Feb. 7 to 9 in Phoenix.

Raed A. Joundi, M.D., D.Phil., from McMaster University in Hamilton, Ontario, Canada, and colleagues used linked administrative databases to compare risk and time course of dementia among all 90-day survivors of first acute ischemic stroke or intracerebral hemorrhage (ICH) to controls in the general population and with acute myocardial infarction (AMI). The analysis included 180,940 people with acute stroke matched (1:1) on age, sex, rural residence, neighborhood marginalization, and vascular comorbidities and excluded people with prior dementia.

The researchers found that during a mean follow-up of 5.5 years, 33,765 individuals with acute stroke (18.7 percent) developed dementia. The rate of dementia was highest after acute stroke when compared with the general population (3.40 versus 1.88 per 100 person-years) and versus AMI (3.23 versus 1.81 per 100 person-years). Compared with the general population, the overall risk for dementia was higher in those with acute stroke (hazard ratio [HR], 1.79) and particularly after ICH (HR, 2.43). Results were similar compared with AMI (HR, 1.77). In the first year after stroke, there was an almost threefold higher risk for dementia, which decreased to 1.5-fold by five years but remained elevated even 20 years after.

Our findings reinforce the importance of monitoring people with stroke for cognitive decline, instituting appropriate treatments to address vascular risk factors and prevent recurrent stroke, and encouraging lifestyle changes, such as smoking cessation and increased physical activity, which have many benefits and may reduce the risk of dementia, Joundi said in a statement.

Several authors disclosed ties to industry.

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