INCIDENCE AND DETERMINANTS OF POSTSTROKE DEMENTIA AS DEFINED BY AN INFORMANT INTERVIEW METHOD IN A HOSPITAL-BASED STROKE REGISTRY

Background and Purpose-inconsistent information about incidence and de terminants of poststroke dementia might be related to patient attritio n, partly because of nonapplicability of formal neuropsychological tes ting to a large proportion of patients registered in a definite settin g. Methods-Using a proxy-informant interview based on ICD-10 criteria, we determined dementia at stroke onset and 1 year after stroke in the 339 patients who survived, were available for follow-up, and were not demented at stroke onset of 635 patients entered over a 1-year period in a stroke registry taken at 2 community hospitals in Florence, Ital y. Results-Of the 339 patients, 57 (16.8%) proved to have poststroke d ementia. These patients were older, more frequently female, and more o ften (multivariate odds ratio, 2.35; 95% CI, 1.21 to 4.58) had atrial fibrillation than those without dementia. Aphasia and the clinical fea tures expressing the severity of the stroke event in the acute phase p redicted poststroke dementia. Conclusions-In a hospital-based nonselec ted series of stroke survivors, despite the use of a method with low s ensitivity for defining dementia, our study confirms that dementia is a frequent sequela of stroke and is mainly predicted by stroke severit y. Certain determinants could be controlled in the prestroke phase, th us reducing its risk.