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Delayed‐onset dementia after stroke or transient ischemic attack
Author(s) -
Mok Vincent C.T.,
Lam Bonnie Y.K.,
Wang Zhaolu,
Liu Wenyan,
Au Lisa,
Leung Eric Y.L.,
Chen Sirong,
Yang Jie,
Chu Winnie C.W.,
Lau Alexander Y.L.,
Chan Anne Y.Y.,
Shi Lin,
Fan Florence,
Ma Sze H.,
Ip Vincent,
Soo Yannie O.Y.,
Leung Thomas W.H.,
Kwok Timothy C.Y.,
Ho Chi L.,
Wong Lawrence K.S.,
Wong Adrian
Publication year - 2016
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2016.05.007
Subject(s) - dementia , stroke (engine) , medicine , vascular dementia , cognitive decline , diabetes mellitus , cardiology , disease , pediatrics , endocrinology , mechanical engineering , engineering
Patients surviving stroke without immediate dementia are at high risk of delayed‐onset dementia. Mechanisms underlying delayed‐onset dementia are complex and may involve vascular and/or neurodegenerative diseases. Methods Dementia‐free patients with stroke and/or transient ischemic attack (TIA; n = 919) were studied for 3 years prospectively, excluding those who developed dementia 3 to 6 months after stroke and/or TIA. Results Forty subjects (4.4%) developed dementia during the study period. Imaging markers of severe small vessel disease (SVD), namely presence of ≥3 lacunes and confluent white matter changes; history of hypertension and diabetes mellitus independently predicted delayed‐onset dementia after adjustment for age, gender, and education. Only 6 of 31 (19.4%) subjects with delayed cognitive decline harbored Alzheimer's disease–like Pittsburg compound B (PiB) retention. Most PiB cases (16/25, 64%) had evidence of severe SVD. Discussion Severe SVD contributes importantly to delayed‐onset dementia after stroke and/or TIA. Future clinical trials aiming to prevent delayed‐onset dementia after stroke and/or TIA should target this high‐risk group.