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Stroke and dementia risk: A systematic review and meta‐analysis
Author(s) -
Kuźma Elżbieta,
Lourida Ilianna,
Moore Sarah F.,
Levine Deborah A.,
Ukoumunne Obioha C.,
Llewellyn David J.
Publication year - 2018
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.2018.06.3061
Subject(s) - meta analysis , stroke (engine) , dementia , hazard ratio , medicine , confidence interval , risk factor , relative risk , disease , mechanical engineering , engineering
Stroke is an established risk factor for all‐cause dementia, though meta‐analyses are needed to quantify this risk. Methods We searched Medline, PsycINFO, and Embase for studies assessing prevalent or incident stroke versus a no‐stroke comparison group and the risk of all‐cause dementia. Random effects meta‐analysis was used to pool adjusted estimates across studies, and meta‐regression was used to investigate potential effect modifiers. Results We identified 36 studies of prevalent stroke (1.9 million participants) and 12 studies of incident stroke (1.3 million participants). For prevalent stroke, the pooled hazard ratio for all‐cause dementia was 1.69 (95% confidence interval: 1.49–1.92; P < .00001; I 2 = 87%). For incident stroke, the pooled risk ratio was 2.18 (95% confidence interval: 1.90–2.50; P < .00001; I 2 = 88%). Study characteristics did not modify these associations, with the exception of sex which explained 50.2% of between‐study heterogeneity for prevalent stroke. Discussion Stroke is a strong, independent, and potentially modifiable risk factor for all‐cause dementia.