International Journal of Stroke ( IF 6.7 ) Pub Date : 2021-06-10 , DOI: 10.1177/17474930211026519 Moamina Ismail 1 , Vincent Ct Mok 1, 2, 3 , Adrian Wong 1, 2 , Lisa Au 1, 2 , Brian Yiu 1, 2 , Zhaolu Wang 4 , Winnie Cw Chu 5 , Anne Yy Chan 1 , Florence Sy Fan 1 , Sze H Ma 1 , Vincent Ip 1 , Bonaventure Ip 1 , Karen Ma 1 , Howan Leung 1 , Yannie Oy Soo 1 , Thomas Wh Leung 1 , Ho Ko 1, 2, 6 , Alexander Yl Lau 1, 2 , Bonnie Yk Lam 1, 2, 3
Background
Stroke not only substantially increases the risk of incident dementia early after stroke, the risk remains elevated years after.
Aim
We aimed to determine the risk factors of dementia onset more than 3-6 months after stroke or transient ischemic attack (TIA).
Methods
This is a single center prospective cohort study. We recruited consecutive subjects with stroke/TIA without early-onset dementia. We conducted an annual neuropsychological assessment for 5 years. We investigated the association between baseline demographic, clinical, genetic (APOEε4 allele), and radiological factors, as well as incident recurrent stroke, with delayed-onset dementia using Cox proportional hazards models.
Results
1,007 patients were recruited, of which 88 with early-onset dementia and 162 who lost to follow-ups were excluded. 49 (6.5%) out of 757 patients have incident delayed-onset dementia. The presence of ⥠3 lacunes, history of ischemic heart disease (IHD), history of ischemic stroke and a lower baseline Hong Kong version of the Montreal Cognitive Assessment (MoCA) score, were significantly associated with delayed-onset dementia. APOEε4 allele, medial temporal lobe atrophy, and recurrent stroke were not predictive.
Conclusion
The presence of ⥠3 lacunes, history of IHD, history of ischemic stroke and a lower baseline MoCA score, are associated with delayed-onset dementia after stroke/TIA.