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P2‐300: INCIDENCE AND PREDICTIVE FACTORS OF COGNITIVE DYSFUNCTION SIX MONTHS AFTER ACUTE STROKE
Author(s) -
Ishiwata Akiko,
Nogami Akane,
Sato Takahiro,
Nagai Koichiro,
Suda Satoshi,
Kimura Kazumi
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.2018.06.989
Subject(s) - montreal cognitive assessment , stroke (engine) , medicine , incidence (geometry) , dementia , cognition , neuropsychology , physical therapy , outpatient clinic , prospective cohort study , mini–mental state examination , acute stroke , pediatrics , psychiatry , disease , tissue plasminogen activator , engineering , mechanical engineering , physics , optics
Background: There is general acknowledgement of the importance of early diagnosis of dementia, yet there are still high rates of undetected dementia internationally. The aim of this crosssectional study was to determine the sociodemographic characteristics associated with possible undetected dementia in a large sample of community-dwelling older New Zealanders. Methods: The sample consisted of older people (age 65) who had received the homecare version of the international Residential Assessment (interRAI HC 9.1) over a 2-year period and who were screened positive for possible dementia on the interRAI’s Cognitive Performance Scale. People with possible alternative explanations for cognitive impairment such as depression and other neurological conditions were excluded. The 5202 eligible individuals were categorized into two groups: (1) those with a recorded diagnosis of dementia (64%) and (2) those without a recorded diagnosis of dementia (36%). Logistic regression was used to evaluate the association between individual characteristics and possible undetected dementia. Results: The mean age for the possible undetected dementia group (UDG) was significantly higher than the diagnosed dementia group (DDG) (83.6 years, SD67.7 vs 82.6 years, SD67.0; p1⁄40.000). Compared with the DDG, subjects in the possible UDG were less likely to be married or in a de facto relationship (37.6% vs 54.5%, p1⁄40.000) and more likely to be living alone (42.8% vs 26.4%, p1⁄40.000) (OR1⁄42.01, CI1⁄41.75-2.30). Compared with the DDG, subjects in the possible UDG were significantly (i) less likely to have participated in social activities of long standing interest (42.6% vs 52.6%, p1⁄40.000) (OR1⁄41.37, CI1⁄41.211.56), (ii) more likely to have experienced major life stressors (52.1% vs 35.2% p1⁄40.000) (OR1⁄41.88, CI1⁄41.65-2.14), and (iii) more likely to report limited access to home or rooms in home (8.6% vs 5.9%, p1⁄40.000) (OR1⁄41.44, CI1⁄41.13-1.84). Ethnicity had a significance effect on the diagnosis of dementia (p1⁄40.012); Asian people has a greater risk of being in the possible undetected dementia group (OR1⁄41.91, CI1⁄41.33-2.74). Conclusions: Our results could help to identify the individual characteristics that play a role in the under-diagnosis of dementia in the local context, and guide interventions to promote early diagnosis in vulnerable groups. P2-300 INCIDENCE AND PREDICTIVE FACTORS OF COGNITIVE DYSFUNCTION SIX MONTHS AFTER ACUTE STROKE