High Incidence of Dementia Conversion than Stroke Recurrence in Poststroke Patients of Late Elder Society

Background This study investigated the incidence of current poststroke dementia (PSD), the annual conversion ratio into PSD, and the risk factors for conversion. Methods In a 4.8-year follow-up period, 112 poststroke patients (ischemic stroke and intracerebral hemorrhage) were retrospectively invest...

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Veröffentlicht in:Journal of stroke and cerebrovascular diseases 2015-07, Vol.24 (7), p.1621-1628
Hauptverfasser: Nakano, Yumiko, MD, Deguchi, Kentaro, MD, PhD, Yamashita, Toru, MD, PhD, Morihara, Ryuta, MD, Matsuzono, Kosuke, MD, Kawahara, Yuko, MD, Sato, Kota, MD, PhD, Kono, Syoichiro, MD, PhD, Hishikawa, Nozomi, MD, PhD, Ohta, Yasuyuki, MD, PhD, Higashi, Yasuto, MD, Takao, Yoshiki, MD, PhD, Abe, Koji, MD, PhD
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container_end_page 1628
container_issue 7
container_start_page 1621
container_title Journal of stroke and cerebrovascular diseases
container_volume 24
creator Nakano, Yumiko, MD
Deguchi, Kentaro, MD, PhD
Yamashita, Toru, MD, PhD
Morihara, Ryuta, MD
Matsuzono, Kosuke, MD
Kawahara, Yuko, MD
Sato, Kota, MD, PhD
Kono, Syoichiro, MD, PhD
Hishikawa, Nozomi, MD, PhD
Ohta, Yasuyuki, MD, PhD
Higashi, Yasuto, MD
Takao, Yoshiki, MD, PhD
Abe, Koji, MD, PhD
description Background This study investigated the incidence of current poststroke dementia (PSD), the annual conversion ratio into PSD, and the risk factors for conversion. Methods In a 4.8-year follow-up period, 112 poststroke patients (ischemic stroke and intracerebral hemorrhage) were retrospectively investigated in cognitive examinations. They were categorized into 3 subgroups: converters into PSD, nonconverters who maintained their normal cognitive functions, and reverters who recovered to the normal mentality range. The clinical and demographic characteristics of these 3 subgroups were analyzed. Results Among all 112 poststroke patients (61.6% male, 73.6 ± 10.4 years old), 16.1% had PSD. During the follow-up period, a part of the normal baseline mentality group (83.9% of 112 original patients) newly developed PSD (subdivided into converters) with an annual conversion rate of 7.6%. The reversion rate from the baseline PSD group was 11.3%. There were significant differences in age ( P < .05), baseline mini-mental state examination scores ( P < .05), body mass index ( P < .05), and periventricular and deep white matter hyperintensity grades ( P  < .05 and P  = .01, respectively) between converters and nonconverters. The annual rate of stroke recurrence was only 2.2% in all stroke subtypes. Conclusions In comparison with stroke recurrence (2.2%), 7.6% of the annual PSD conversion rate was very high. Therefore, prevention of direct conversion into PSD without stroke recurrence may be another important aspect of poststroke clinics, especially in late elder society.
doi_str_mv 10.1016/j.jstrokecerebrovasdis.2015.03.037
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Methods In a 4.8-year follow-up period, 112 poststroke patients (ischemic stroke and intracerebral hemorrhage) were retrospectively investigated in cognitive examinations. They were categorized into 3 subgroups: converters into PSD, nonconverters who maintained their normal cognitive functions, and reverters who recovered to the normal mentality range. The clinical and demographic characteristics of these 3 subgroups were analyzed. Results Among all 112 poststroke patients (61.6% male, 73.6 ± 10.4 years old), 16.1% had PSD. During the follow-up period, a part of the normal baseline mentality group (83.9% of 112 original patients) newly developed PSD (subdivided into converters) with an annual conversion rate of 7.6%. The reversion rate from the baseline PSD group was 11.3%. There were significant differences in age ( P &lt; .05), baseline mini-mental state examination scores ( P &lt; .05), body mass index ( P &lt; .05), and periventricular and deep white matter hyperintensity grades ( P  &lt; .05 and P  = .01, respectively) between converters and nonconverters. The annual rate of stroke recurrence was only 2.2% in all stroke subtypes. Conclusions In comparison with stroke recurrence (2.2%), 7.6% of the annual PSD conversion rate was very high. Therefore, prevention of direct conversion into PSD without stroke recurrence may be another important aspect of poststroke clinics, especially in late elder society.</description><identifier>ISSN: 1052-3057</identifier><identifier>EISSN: 1532-8511</identifier><identifier>DOI: 10.1016/j.jstrokecerebrovasdis.2015.03.037</identifier><identifier>PMID: 25910873</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Age Factors ; Aged ; Aged, 80 and over ; Cardiovascular ; Cognition ; Dementia - diagnosis ; Dementia - epidemiology ; Dementia - psychology ; Female ; Humans ; Incidence ; Japan - epidemiology ; late elder society ; Male ; Middle Aged ; Neurology ; Poststroke dementia ; Prognosis ; Recovery of Function ; Recurrence ; Retrospective Studies ; Risk Factors ; secondary prevention ; Stroke - diagnosis ; Stroke - epidemiology ; Stroke - psychology ; stroke recurrence ; Time Factors ; vascular risk factors</subject><ispartof>Journal of stroke and cerebrovascular diseases, 2015-07, Vol.24 (7), p.1621-1628</ispartof><rights>National Stroke Association</rights><rights>2015 National Stroke Association</rights><rights>Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c595t-a308e93d8c511f075080eb1a2a7eb6be62f7df6b86ab2a49b5fab2a002ee52123</citedby><cites>FETCH-LOGICAL-c595t-a308e93d8c511f075080eb1a2a7eb6be62f7df6b86ab2a49b5fab2a002ee52123</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2015.03.037$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25910873$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nakano, Yumiko, MD</creatorcontrib><creatorcontrib>Deguchi, Kentaro, MD, PhD</creatorcontrib><creatorcontrib>Yamashita, Toru, MD, PhD</creatorcontrib><creatorcontrib>Morihara, Ryuta, MD</creatorcontrib><creatorcontrib>Matsuzono, Kosuke, MD</creatorcontrib><creatorcontrib>Kawahara, Yuko, MD</creatorcontrib><creatorcontrib>Sato, Kota, MD, PhD</creatorcontrib><creatorcontrib>Kono, Syoichiro, MD, PhD</creatorcontrib><creatorcontrib>Hishikawa, Nozomi, MD, PhD</creatorcontrib><creatorcontrib>Ohta, Yasuyuki, MD, PhD</creatorcontrib><creatorcontrib>Higashi, Yasuto, MD</creatorcontrib><creatorcontrib>Takao, Yoshiki, MD, PhD</creatorcontrib><creatorcontrib>Abe, Koji, MD, PhD</creatorcontrib><title>High Incidence of Dementia Conversion than Stroke Recurrence in Poststroke Patients of Late Elder Society</title><title>Journal of stroke and cerebrovascular diseases</title><addtitle>J Stroke Cerebrovasc Dis</addtitle><description>Background This study investigated the incidence of current poststroke dementia (PSD), the annual conversion ratio into PSD, and the risk factors for conversion. Methods In a 4.8-year follow-up period, 112 poststroke patients (ischemic stroke and intracerebral hemorrhage) were retrospectively investigated in cognitive examinations. They were categorized into 3 subgroups: converters into PSD, nonconverters who maintained their normal cognitive functions, and reverters who recovered to the normal mentality range. The clinical and demographic characteristics of these 3 subgroups were analyzed. Results Among all 112 poststroke patients (61.6% male, 73.6 ± 10.4 years old), 16.1% had PSD. During the follow-up period, a part of the normal baseline mentality group (83.9% of 112 original patients) newly developed PSD (subdivided into converters) with an annual conversion rate of 7.6%. The reversion rate from the baseline PSD group was 11.3%. There were significant differences in age ( P &lt; .05), baseline mini-mental state examination scores ( P &lt; .05), body mass index ( P &lt; .05), and periventricular and deep white matter hyperintensity grades ( P  &lt; .05 and P  = .01, respectively) between converters and nonconverters. The annual rate of stroke recurrence was only 2.2% in all stroke subtypes. Conclusions In comparison with stroke recurrence (2.2%), 7.6% of the annual PSD conversion rate was very high. Therefore, prevention of direct conversion into PSD without stroke recurrence may be another important aspect of poststroke clinics, especially in late elder society.</description><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cardiovascular</subject><subject>Cognition</subject><subject>Dementia - diagnosis</subject><subject>Dementia - epidemiology</subject><subject>Dementia - psychology</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Japan - epidemiology</subject><subject>late elder society</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Poststroke dementia</subject><subject>Prognosis</subject><subject>Recovery of Function</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>secondary prevention</subject><subject>Stroke - diagnosis</subject><subject>Stroke - epidemiology</subject><subject>Stroke - psychology</subject><subject>stroke recurrence</subject><subject>Time Factors</subject><subject>vascular risk factors</subject><issn>1052-3057</issn><issn>1532-8511</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqVkkFr3DAQhUVpadK0f6HoWArejOSVLV8K7SZtAgsJ2fYsZHncyPFKqSQv7L-vnE1zCLkUBjSHp_c0n4aQzwwWDFh1OiyGmIK_Q4MB2-B3OnY2LjgwsYAyV_2KHDNR8kIKxl7nHgQvShD1EXkX4wDAmJDiLTniomEg6_KY2Av7-5ZeOmM7dAap7-kZbtElq-nKux2GaL2j6VY7unkIpzdophAe1NbRax_T4VX0Wiebb8bZZK0T0vOxw0A33lhM-_fkTa_HiB8ezxPy6_v5z9VFsb76cbn6ui6MaEQqdAkSm7KTJs_QQy1AArZMc11jW7VY8b7u-qqVlW65Xjat6OcGgCMKznh5Qj4dfO-D_zNhTGpro8Fx1A79FBWrpASoAWSWfjtITfAxBuzVfbBbHfaKgZqRq0G9hFzNyBWUueps8vExb2q32D1Z_GOcBeuDAPPUO4tBxQwk4-tsQJNU5-3_5X15ZmdG66zR4x3uMQ5-Ci7zVUxFrkBt5iWYd4CJ_P_LZln-BQCHtvE</recordid><startdate>20150701</startdate><enddate>20150701</enddate><creator>Nakano, Yumiko, MD</creator><creator>Deguchi, Kentaro, MD, PhD</creator><creator>Yamashita, Toru, MD, PhD</creator><creator>Morihara, Ryuta, MD</creator><creator>Matsuzono, Kosuke, MD</creator><creator>Kawahara, Yuko, MD</creator><creator>Sato, Kota, MD, PhD</creator><creator>Kono, Syoichiro, MD, PhD</creator><creator>Hishikawa, Nozomi, MD, PhD</creator><creator>Ohta, Yasuyuki, MD, PhD</creator><creator>Higashi, Yasuto, MD</creator><creator>Takao, Yoshiki, MD, PhD</creator><creator>Abe, Koji, MD, PhD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150701</creationdate><title>High Incidence of Dementia Conversion than Stroke Recurrence in Poststroke Patients of Late Elder Society</title><author>Nakano, Yumiko, MD ; 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Methods In a 4.8-year follow-up period, 112 poststroke patients (ischemic stroke and intracerebral hemorrhage) were retrospectively investigated in cognitive examinations. They were categorized into 3 subgroups: converters into PSD, nonconverters who maintained their normal cognitive functions, and reverters who recovered to the normal mentality range. The clinical and demographic characteristics of these 3 subgroups were analyzed. Results Among all 112 poststroke patients (61.6% male, 73.6 ± 10.4 years old), 16.1% had PSD. During the follow-up period, a part of the normal baseline mentality group (83.9% of 112 original patients) newly developed PSD (subdivided into converters) with an annual conversion rate of 7.6%. The reversion rate from the baseline PSD group was 11.3%. There were significant differences in age ( P &lt; .05), baseline mini-mental state examination scores ( P &lt; .05), body mass index ( P &lt; .05), and periventricular and deep white matter hyperintensity grades ( P  &lt; .05 and P  = .01, respectively) between converters and nonconverters. The annual rate of stroke recurrence was only 2.2% in all stroke subtypes. Conclusions In comparison with stroke recurrence (2.2%), 7.6% of the annual PSD conversion rate was very high. Therefore, prevention of direct conversion into PSD without stroke recurrence may be another important aspect of poststroke clinics, especially in late elder society.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25910873</pmid><doi>10.1016/j.jstrokecerebrovasdis.2015.03.037</doi><tpages>8</tpages></addata></record>
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subjects Age Factors
Aged
Aged, 80 and over
Cardiovascular
Cognition
Dementia - diagnosis
Dementia - epidemiology
Dementia - psychology
Female
Humans
Incidence
Japan - epidemiology
late elder society
Male
Middle Aged
Neurology
Poststroke dementia
Prognosis
Recovery of Function
Recurrence
Retrospective Studies
Risk Factors
secondary prevention
Stroke - diagnosis
Stroke - epidemiology
Stroke - psychology
stroke recurrence
Time Factors
vascular risk factors
title High Incidence of Dementia Conversion than Stroke Recurrence in Poststroke Patients of Late Elder Society
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