Multiple Strokes Linked to Higher Risk for Post-Stroke Dementia

Characteristics of the stroke itself more important than underlying vascular risks

28 sept 2009-- The risk of developing dementia after stroke is higher in patients who have had multiple strokes, according to a study published online Sept. 24 in The Lancet Neurology.

Sarah T. Pendlebury and Peter M. Rothwell of John Radcliffe Hospital in Oxford, U.K., conducted a review and meta-analysis of studies published over a period of almost 60 years to May 2009, and analyzed 73 papers comprising 7,511 patients in eight population-based and 22 hospital-based cohorts.

Approximately 10 percent of patients had dementia before the occurrence of the first stroke, 10 percent were newly diagnosed with dementia after their first stroke, and over a third of cases with recurrent stroke had dementia, the investigators found. The most important predictors of post-stroke dementia were the characteristics of the stroke and multiple occurrence of stroke, not underlying vascular risk factors, the researchers note.

"Optimum acute stroke care and secondary prevention of stroke are likely to be effective for reducing the burden of post-stroke dementia," the authors write. "Further studies are needed to identify independent predictive factors, to develop a risk factor score for use in clinical practice and trials, and to ascertain the relative contributions of and interactions between degenerative and vascular processes in the causes of post-stroke dementia."

Abstract
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