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Dementia risk doubles in stroke patients
.
In Ontario, Canada, rates of stroke and dementia declined simultaneously over a 12-year period, most notably in people aged 80 and older
Furthermore, this may also be the result of improved management of vascular risk factors , as most risk factors are common to stroke and dementia .
However, the overall effect of better risk factor control was modest, appeared to primarily affect executive function, and was inconsistent across studies .
At the same time, the decline in dementia may also have been affected by the increased use of intravenous thrombolysis over time
.
Ontario implemented Canada's first comprehensive system of stroke care, aimed at improving the quality and delivery of specialty stroke services across the province, which was associated with an increase in the use of thrombolytic therapy for ischemic stroke from 10 per cent in 2002/2003 to 2008/2008.
27% in 2009
In this way, Joshua O.
Cerasuolo et al.
stroke
Despite the extensive literature supporting the clinical benefit of intravenous thrombolysis for functional independence, little is known about the relationship between intravenous thrombolysis and dementia risk after a first ischemic stroke
.
They included first-time ischemic stroke patients with no previous diagnosis of dementia from the Ontario Stroke Registry
.
The primary clinical outcome was unexpected dementia as determined by a valid diagnostic algorithm
diagnosis
From July 2003 to March 2013, a total of 7072 patients with ischemic stroke were included, 3276 (46.
3%) were female, and the mean age was 71.
0 (SD, 12.
8) years
.
Overall, 38.
2% of the cohort (n=2705) received thrombolysis, of which 77.
2% (n=2087) were administered within 3 hours of stroke onset
.
In the first year after stroke, thrombolysis was associated with a 24% relative reduction in the incidence of dementia (cause-specific hazard ratio, 0.
76 [95% CI, 0.
58-0.
97])
.
This association was observed after 5 years (cause-specific hazard ratio, 0.
Thrombolysis linked to 24% relative reduction in dementia incidence
The significance of this study is its finding that thrombolysis after a first ischemic stroke is independently associated with a reduction in dementia rates
.
New-onset dementia should be included as a relevant clinical outcome when assessing the risk/benefit of thrombolytic therapy in patients with ischemic stroke
Thrombolysis after first ischemic stroke is independently associated with reduced dementia rates
Original source:
Cerasuolo JO, Mandzia J, Cipriano LE, et al.
Intravenous Thrombolysis After First-Ever Ischemic Stroke and Reduced Incident Dementia Rate.
Stroke .
ntravenous Thrombolysis After First-Ever Ischemic Stroke and Reduced Incident Dementia Rate.
Stroke
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