Prestroke dementia

Objective: To determine the frequency, associated factors and outcome of de mentia previous to a stroke. Design: Cross-sectional study of a cohort of 3 24 consecutive unselected stroke patients (mean age 70.9 years, range 20-98 ; 255 ischaemic, 46 haemorrhagic and 25 indefinite). Methods: Cognitive and functional status prior to stroke were assessed by means of an interview t o a relative, a short version of the Informant Questionnaire on Cognitive D ecline in the Elderly and the Barthel Index. The DSM-III-R criteria were us ed to establish the diagnosis of prestroke dementia. Clinical and CT featur es of patients with and without prestroke dementia were compared. Results: Forty-nine patients (15%) were demented before stroke; they were significan tly older, less well educated, they had more frequently female gender, prio r cerebrovascular disease, cerebral and medial temporal lobe atrophy and le ukoaraiosis in the CT scan, and they had a higher mortality rate. Female se x (OR 3.7, CI 95% 1.2-12), low education (OR 2.1, Cl 95% 1.1-4.2), previous stroke (OR 3.6, Cl 95% 1.2-11), and cerebral atrophy (OR 3.8, Cl 95% 1.7-8 .3) were independently associated with prestroke dementia in the logistic r egression analysis. Conclusions: Fifteen percent of stroke patients have pr estroke dementia and they have a worse outcome. Factors associated with pre stroke dementia are reminiscent both of degenerative and vascular brain pat hology. Copyright (C) 2001 S. Karger AG. Basel.