BACKGROUND Besides disability in stroke survivors, vascular cognitive impairment (VCI) can prevent these patients from living independently. The purpose of this study is to look for the incidence and risk factors of vascular dementia in Thai patients with stroke. METHODS Adults patients with ischemic stroke were prospectively included. Cognitive assessment was performed at 3-6 months after stroke onset. Montreal Cognitive Assessment (MOCA)- Thai version was used to evaluate cognitive function, with the cutoff point of 24/25 of MOCA to define cognitive impairment/normal cognition. Vascular mild cognitive impairment (VMCI) and vascular dementia (VAD) were diagnosed in those with cognitive impairment. Epidemiologic data, Apolipoprotein E (ApoE) status, and stroke characteristics were compared between patients with and without VAD. RESULTS There were 180 patients with the mean age of 65 years. Median time after stroke onset to have cognitive assessment was 6 months. Ninety patients (50%) had VMCI. VAD was diagnosed in 49 patients (27%). Mean Thai version of mental state examination (TMSE) and MOCA scores in patients with VAD were 20 and 12, respectively. Multivariate analysis showed that older age (OR 4.994, 95%CI 1.602-15.565, p-value = 0.006), lower education (OR 10.306, 95%CI 3.162-33.586, p-value < 0.001), history of stroke (OR 4.959, 95%CI 1.036-23.741, p-value = 0.045) and moderate to severe cerebral white matter lesions (OR 5.555, 95%CI 1.710-18.041, p-value = 0.004) were associated with VAD. ApoE 4 allele was found in 25% of the patients, but the presence did not show any association with the increased risk of VAD. CONCLUSIONS VAD occurred in 27% of the stroke patients. Older age, low education level, history of stroke, and the presence of moderate to severe white matter lesions were associated with the increased risk of VAD.

中文翻译：

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泰国中风患者血管性痴呆的发病率和危险因素。

背景技术除了中风幸存者的残疾外，血管性认知障碍（VCI）还可阻止这些患者独立生活。这项研究的目的是寻找泰国中风患者血管性痴呆的发生率和危险因素。方法前瞻性纳入成人缺血性中风患者。在中风发作后3-6个月进行认知评估。蒙特利尔认知评估（MOCA）-泰文版用于评估认知功能，MOCA的临界点为24/25，以定义认知障碍/正常认知。在患有认知障碍的患者中诊断出了血管轻度认知障碍（VMCI）和血管性痴呆（VAD）。比较有无VAD患者的流行病学数据，载脂蛋白E（ApoE）状态和中风特征。结果180例患者的平均年龄为65岁。中风发作后进行认知评估的中位时间为6个月。90名患者（50％）患有VMCI。在49例患者中诊断出VAD（27％）。VAD患者的泰国平均精神状态检查（TMSE）和MOCA评分分别为20和12。多因素分析显示，老年人（OR 4.994，95％CI 1.602-15.565，p-值= 0.006），较低的教育（OR 10.306，95％CI 3.162-33.586，p-值<0.001），中风病史（OR 4.959） ，95％CI 1.036-23.741，p值= 0.045）和中度至重度脑白质病变（OR 5.555，95％CI 1.710-18.041，p值= 0.004）与VAD相关。在25％的患者中发现了ApoE 4等位基因，但该存在与VAD风险增加没有关联。结论VAD发生在27％的中风患者中。年龄大，文化程度低，中风病史以及中度至重度白质病变的存在与VAD风险增加有关。