Long-Term Risk of Dementia Among Survivors of Ischemic or Hemorrhagic Stroke
Long-Term Risk of Dementia Among Survivors of Ischemic or Hemorrhagic Stroke
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DOI：
10.1161/strokeaha.116.015242
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发表时间：
2017-01-01
期刊：
影响因子：
8.3
通讯作者：
Sorensen, Henrik T.
中科院分区：
文献类型：
--
作者：
Corraini, Priscila;Henderson, Victor W.;Sorensen, Henrik T.
背景和目的-卒中是痴呆的危险因素，但对不同类型卒中后痴呆的风险知之甚少。我们研究了任何首次中风和首次缺血性中风，脑出血和蛛网膜下腔hemorrhages. Methods，我们进行了一项为期30年的全国性人群为基础的队列研究，使用丹麦医学数据库（1982-2013年）的数据，涵盖所有丹麦医院的幸存者痴呆症的长期风险。我们确定了84220例缺血性卒中幸存者，16723例脑出血幸存者，9872例蛛网膜下腔出血幸存者和104303例未指明卒中类型的幸存者。患者年龄≥ 18岁，诊断后至少存活3个月。我们从一般人群中形成了一个比较队列（1075588例无卒中患者，按年龄和性别与卒中患者相匹配）。我们计算了卒中后30年内痴呆的绝对风险和风险比，结果卒中幸存者30年内痴呆的绝对风险为11.5%（95%可信区间，11.2%-11.7%）。与一般人群相比，卒中幸存者痴呆的风险比（95%置信区间）为任何卒中后1.80（1.77-1.84），缺血性卒中后1.72（1.66-1.77），脑出血后2.70（2.53-2.89），蛛网膜下腔出血后2.74（2.45-3.06）。无论卒中类型如何，年轻患者比老年患者面临更高的卒中后痴呆风险。中风类型的风险比模式在随访期间没有改变，也没有明显改变的年龄，性别，或预先存在的诊断血管conditions. Conclusions-Strokeincreasesdementionik. Survivorsofintracerebralbrandandsubarachnoidasheageareatespecially高的中风后痴呆的长期风险。
Background and Purpose-Stroke is a risk factor for dementia, but the risk of dementia after different stroke types is poorly understood. We examined the long-term risk of dementia among survivors of any first-time stroke and of first-time ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage.Methods-We conducted a 30-year nationwide population-based cohort study using data from Danish medical databases (1982-2013) covering all Danish hospitals. We identified 84 220 ischemic stroke survivors, 16 723 intracerebral hemorrhage survivors, 9872 subarachnoid hemorrhage survivors, and 104 303 survivors of unspecified stroke types. Patients were aged >= 18 years and survived for at least 3 months after diagnosis. We formed a comparison cohort from the general population (1 075 588 patients without stroke, matched to stroke patients by age and sex). We computed absolute risks and hazard ratios of dementia up to 30 years after stroke.Results-The 30-year absolute risk of dementia among stroke survivors was 11.5% (95% confidence interval, 11.2%11.7%). Compared with the general population, the hazard ratio (95% confidence interval) for dementia among stroke survivors was 1.80 (1.77-1.84) after any stroke, 1.72 (1.66-1.77) after ischemic stroke, 2.70 (2.53-2.89) after intracerebral hemorrhage, and 2.74 (2.45-3.06) after subarachnoid hemorrhage. Younger patients regardless of stroke type faced higher risks of poststroke dementia than older patients. The pattern of hazard ratios by stroke type did not change during followup and was not altered appreciably by age, sex, or preexisting diagnoses of vascular conditions.Conclusions-Strokeincreasesdementiarisk.Survivorsofintracerebralhemorrhageandsubarachnoidhemorrhageareatparticularly high long-term risk of poststroke dementia.