Stroke: Depression and diabetes are associated with the onset of dementia after stroke

According to statistics, there are more than 25 million post-stroke patients worldwide each year.
about 18% of these patients under the disease are treated for long-term rehabilitation (LTC) within 180 days of the illness.
, the majority of patients with LTC had poor quality of life and often failed to return to a normal standard of living.
, a large number of stroke patients have created a huge financial burden on society.
showed that 10 percent of post-stroke patients develop cognitive dysfunction or even dementia for the first time since beset.
cognitive dysfunction after stroke is also often considered an indicator of long-term prognosmation.
about one-t4 percent of stroke survivors still experience severe cognitive impairment during LTC treatment.
and depression are the most common conditions.
, diabetics were more than twice as likely to develop depression as non-diabetics.
previous studies have shown that stroke patients tend to have worse cognitive impairments when combined with diabetes and depression, but the risk of long-term dementia remains uncertain.
, a team from the University of Toronto in Canada looked at the long-term effects of depression, diabetes and post-stroke dementia.
study was published in the journalSTROKE.
study provided a retrospective analysis of forward-looking data on patients with non-pre-disease dementia who were continuously treated in the Ontario Stroke Registry (OSR).
first acute ischemic stroke between 2003 and 2013 and went to a comprehensive stroke center in Ontario, Canada.
a history of diabetes and depression diagnosed within 5 years of being admitted to hospital with a stroke.
assessed the risk ratio of dementia after stroke, re-hospitalization of stroke or TIA over time, and total risk of death.
included 23,579 stroke patients, of whom 20,201 returned to the community.
, combined diabetes depression in female stroke patients increased the risk of in-hospital death by 87%, while in female stroke patients combined depression alone increased the risk of in-hospital death by 13%.
5.6 years of moderate follow-up, diabetes and co-disease were associated with the need for LTC treatment (X2 s 5.4; P=0.02）。
for stroke patients with a history of diabetes, combined depression was associated with a 55 percent increase in LTC treatment, while stroke patients with combined depression alone had a 19 percent increased risk.
sensitivity analysis showed that this interaction was significant in women (X2 s 6.2; P s 0.01), but not significantly in men (X2 s 0.3; P s 0.6);
further analysis showed that the interaction between pre-stroke diabetes and depression had no significant effect on the development of dementia.
but this interaction had an effect on women (X2 s 4.6; P s 0.03), where women with depression and diabetes had an 85% higher risk of developing dementia.
, women without diabetes had a 28 percent increased risk.
men did not see the interaction.
addition, pre-stroke combined diabetes and depression did not interact with the risk of death or stroke/TIA re-hospitalization.
cumulative occurrence function (CIF) curve for the results after discharge.
, women with a combination of diabetes and depression had a significantly increased risk of developing LTC and dementia after stroke.
therefore need to be targeted in stroke rehabilitation treatment of emotional and metabolic factors such as intervention.
: Ouk M, et al. Depression and Diabetes Mellitus Multimorbidity Is Associated With Loss of Independence and Dementia Poststroke. Stroke. 2020 Dec; 51(12):3531-3540. doi: 10.1161/STROKEAHA.120.031068.MedSci Original Source: MedSci Original Copyright Notice: All noted on this website "Source: Met Medical" or "Source: MedSci Original" text, images and audio-visual materials, copyrights are owned by Metz Medicine, without authorization, no media, website or individual may reproduce, authorized to reproduce with the words "Source: Mets Medicine".
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