Risk factors for incident dementia after stroke and transient ischemic attack

Alzheimers Dement. 2015 Jan;11(1):16-23. doi: 10.1016/j.jalz.2014.01.003. Epub 2014 Mar 3.

Abstract

Background: We hypothesized that chronic brain changes are important substrates for incident dementia after stroke and transient ischemic attack (TIA).

Methods: We compared clinical and imaging features between patients with consecutive stroke/TIA with (n = 88) and without (n = 925) incident dementia at 3 to 6 months after a stroke/TIA. Pittsburg compound B (PiB) positron emission tomography was performed in 50 patients, including those with (n = 37) and without (n = 13) incident dementia.

Results: Age, history of diabetes mellitus, severity of white matter changes (WMCs), and medial temporal lobe atrophy (MTLA) were associated with incident dementia. Alzheimer's disease (AD)--like PiB retention was found in 29.7% and 7.7% (P = .032) of patients with and without incident dementia, respectively.

Conclusions: Chronic brain changes including WMCs, MTLA, and AD pathology are associated with incident dementia after stroke/TIA. Interventions targeting these chronic brain changes may reduce burden of vascular cognitive impairment.

Keywords: Brain atrophy; PiB-PET; Poststroke dementia; Transient ischemic attack; Vascular cognitive impairment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Aniline Compounds
  • Biomarkers / blood
  • Brain / blood supply
  • Brain / diagnostic imaging
  • Brain / pathology
  • Chronic Disease
  • Cohort Studies
  • Cross-Sectional Studies
  • Dementia / diagnostic imaging
  • Dementia / etiology*
  • Dementia / pathology
  • Diabetes Mellitus / pathology
  • Female
  • Humans
  • Ischemic Attack, Transient / complications*
  • Ischemic Attack, Transient / pathology
  • Male
  • Middle Aged
  • Neuroimaging / methods
  • Positron-Emission Tomography / methods*
  • Radiopharmaceuticals
  • Risk Factors
  • Severity of Illness Index
  • Stroke / complications*
  • Stroke / pathology
  • Temporal Lobe / diagnostic imaging
  • Temporal Lobe / pathology
  • Thiazoles
  • White Matter / diagnostic imaging
  • White Matter / pathology

Substances

  • 2-(4'-(methylamino)phenyl)-6-hydroxybenzothiazole
  • Aniline Compounds
  • Biomarkers
  • Radiopharmaceuticals
  • Thiazoles