Alzheimer's & dementia : the journal of the Alzheimer's Association · 2016
Delayed-onset dementia after stroke or transient ischemic attack.
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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
Аннотация
INTRODUCTION: 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.
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.
Предметные рубрики MeSH
AdultAgedAged, 80 and overAniline CompoundsApolipoproteins EBrainDementiaFemaleFluorodeoxyglucose F18Follow-Up StudiesHumansIschemic Attack, TransientLongitudinal StudiesMaleMiddle AgedPhenanthrolinesPositron-Emission TomographyProspective StudiesStrokeThiazolesTime FactorsTomography, X-Ray ComputedYoung Adult