Bejot Y et al. – Dementia after stroke is not independently associated with an increased risk of death at 1 year. In recent years, 1–year case–fatality decreased in demented as well as in and non–demented patients suggesting that improvements in the management of stroke also benefited the most fragile patients.Methods
- From 1985 to 2008, all first-ever strokes were recorded in the population-based stroke registry of Dijon, France (150 000 inhabitants).
- Dementia was diagnosed during the first month following stroke, according to DSM-III and DSM-IV criteria.
- Survival was evaluated at 1 year and multivariate analyses were performed using Cox proportional hazards to identify independent predictive factors.
- The authors recorded 3948 first-ever strokes.
- Among these stroke patients, 3201 (81%) were testable, and of these, 653 (20.4%) had post-stroke dementia (337 women and 316 men).
- Demented patients had lower 1-year survival than patients without dementia (82.9% vs. 86.9%, P = 0.013).
- However, in multivariate analysis, dementia did not appear as an independent predictor of 1-year death.
- In demented stroke patients, age >80 years old, severe handicap at discharge, recurrent stroke within the first year and subarachnoid haemorrhage were associated with a higher risk of 1-year death, and the risk was lower in the study period 2003–2008.