BACKGROUND Dementia is among the most frequent causes of institutionalization. To serve the purpose of preventive strategies, there are no follow-up studies that have evaluated the actual impact of post-stroke dementia on institutionalization. We therefore compared the institutionalization rate and length of stay in an institutional care facility of patients with post-stroke dementia with stroke patients without dementia. METHODS We included 410 consecutive patients aged 55 to 85 years with ischemic stroke who were admitted to Helsinki University Hospital (The SAM cohort). Hospitalization and nursing home admissions were reviewed from national registries. Dementia was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders 3rd edition (DSM-III) criteria using extensive clinical assessments performed 3 months post-stroke. The cohort had a follow-up 21 years later. RESULTS Compared to patients without dementia, post-stroke dementia was associated with shorter survival time (6.60 vs 10.10 years, p < 0.001), shorter time spent not institutionalized (5.40 vs 9.37 years, p < 0.001), but not with time spent permanently institutionalized (0.73 vs 1.10 years, p = 0.08). Post-stroke dementia was associated with higher rates and earlier permanent institutionalization compared to absence of post-stroke dementia (HR 1.53, 95% CI 1.07-2.18) in a Cox regression model adjusting for age, status of living alone at baseline, modified Rankin Scale at baseline, history of atrial fibrillation, and cardiac failure. CONCLUSIONS Post-stroke dementia is associated with earlier permanent institutionalization. Due to significantly shorter survival, the time spent in nursing homes was not significantly longer in patients with post-stroke dementia compared with patients without post-stroke dementia.

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中风后痴呆和永久收容

背景痴呆症是机构化的最常见原因之一。为达到预防策略的目的，尚无后续研究评估中风后痴呆对住院治疗的实际影响。因此，我们比较了卒中后痴呆患者与无痴呆的卒中患者在机构护理机构的住院率和住院时间。方法 我们连续纳入了 410 名年龄在 55 至 85 岁之间且被赫尔辛基大学医院收治的缺血性卒中患者（SAM 队列）。从国家登记处审查了住院和疗养院的入院情况。痴呆症是根据《精神疾病诊断和统计手册》第 3 版 (DSM-III) 标准使用中风后 3 个月进行的广泛临床评估来诊断的。该队列在 21 年后进行了随访。结果 与没有痴呆的患者相比，卒中后痴呆与更短的生存时间（6.60 年对 10.10 年，p < 0.001）、更短的非机构化时间（5.40 对 9.37 年，p < 0.001）相关，但与永久停留时间无关制度化（0.73 vs 1.10 年，p = 0.08）。在调整年龄、基线时独居状况、修正后的 Rankin 的 Cox 回归模型中，与没有卒中后痴呆（HR 1.53，95% CI 1.07-2.18）相比，卒中后痴呆与更高的发病率和更早的永久性住院治疗相关基线时的量表、心房颤动史和心力衰竭。结论 中风后痴呆与较早的永久性收容机构有关。由于生存期明显缩短，