MEDIAL TEMPORAL-LOBE ATROPHY IN STROKE PATIENTS - RELATION TO PREEXISTING DEMENTIA

Objective-The Links between stroke and Alzheimer's disease seem to be closer than expected by chance. In a previous study it was shown that up to 16% of patients admitted for stroke had pre-existing dementia. M edial temporal lobe atrophy (MTLA) is strongly associated with Alzheim er's disease. The aim of this study was to determine the prevalence of MTLA and its relation with pre-existing dementia. Method-The study wa s conducted on 170 consecutive stroke patients (87 women; median age 7 5 years; 152 infarcts), who underwent non-contrast CT with temporal lo be oriented 2 mm contiguous slices at admission. A cut off point of 11 .5 mm was used to differentiate patients with and without MTLA. Pre-ex isting dementia was assessed using the informant questionnaire on cogn itive decline in the elderly (IQCODE) with a cut off score of 104. Res ults-Ninety four patients (55.3%) had MTLA, of whom 23 (24.5%) had pre existing dementia; of 76 patients without MTLA, only four (5.3%) had p re-existing dementia (p = 0.0007). The logistic regression analysis wi th MTLA as dependent variable found the following independent variable s: increasing age (p < 0.05), and global cerebral atrophy scores (p < 0.01). The IQCODE scores just reached significance (p = 0.05). Conclus ion-Stroke patients with MTLA are more likely to have pre-existing dem entia; this suggests that Alzheimer's disease might contribute to the dementia syndrome. A longitudinal follow up is now necessary to determ ine whether stroke patients with MTLA and without pre-existing dementi a are at increased risk of Alzheimer's disease over subsequent years.