Delayed‐onset dementia after stroke or transient ischemic attack. Issue 11 (18th June 2016)

• Record Type: Journal Article
• Authors: Mok, Vincent C.T.; Lam, Bonnie Y.K.; Wang, Zhaolu; Liu, Wenyan; Au, Lisa; Leung, Eric Y.L.; Chen, Sirong; Yang, Jie; Chu, Winnie C.W.; Lau, Alexander Y.L.; Chan, Anne Y.Y.; Shi, Lin; Fan, Florence; Ma, Sze H.; Ip, Vincent; Soo, Yannie O.Y.; Leung, Thomas W.H.; Kwok, Timothy C.Y.; Ho, Chi L.; Wong, Lawrence K.S.; Wong, Adrian
• Is Part Of: Alzheimer's & dementia. Volume 12:Issue 11(2016)
• Page Start: 1167
• Page End: 1176
• Publication Date: 2016-06-18
• Subjects: Delayed‐onset dementia -- Stroke -- Transient ischemic attack -- Small vessel disease -- Alzheimer's disease; Alzheimer's disease -- Periodicals; Alzheimer Disease -- Periodicals; Dementia -- Periodicals; Démence; Maladie d'Alzheimer; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.83
• DOI: 10.1016/j.jalz.2016.05.007
• Languages: English
• ISSNs: 1552-5260

Abstract

Abstract: Introduction: Patients surviving stroke without immediate dementia are at high risk of delayed‐onset dementia. Mechanisms underlying delayed‐onset dementia are complex and may involve vascular and/or neurodegenerative diseases. Methods: Dementia‐free patients with stroke and/or transient ischemic attack (TIA; n = 919) were studied for 3 years prospectively, excluding those who developed dementia 3 to 6 months after stroke and/or TIA. Results: Forty subjects (4.4%) developed dementia during the study period. Imaging markers of severe small vessel disease (SVD), namely presence of ≥3 lacunes and confluent white matter changes; history of hypertension and diabetes mellitus independently predicted delayed‐onset dementia after adjustment for age, gender, and education. Only 6 of 31 (19.4%) subjects with delayed cognitive decline harbored Alzheimer's disease–like Pittsburg compound B (PiB) retention. Most PiB cases (16/25, 64%) had evidence of severe SVD. Discussion: Severe SVD contributes importantly to delayed‐onset dementia after stroke and/or TIA. Future clinical trials aiming to prevent delayed‐onset dementia after stroke and/or TIA should target this high‐risk group.