Abstract

Introduction: The prevalence rate of Post-Ischemic Stroke Dementia (PISD) is remarkable, and this cerebrovascular disease may increase the risk of incident dementia. However, demographic parameters associated with the PISD are often not well understood.

Objective: To determine the prevalence of PISD, and to calculate the risk ratio of each of the demographic factors in association with its occurrence in a hospital-based study (Guilan province).

Materials and Methods: In a retrospective cohort study, 206 patients, approximately six months post stroke were selected by consecutive and nonprobability sampling method among 760 eligible patients who were discharged from Neurology Department Clinic of Poursina Hospital in Rasht city, from April 2012 to May 2014. All patients underwent a multi-dimensional neurological examination, CT scans and MRI findings inspection, evaluation of the current and premorbid cognitive status by IQCODE and ACE-III tests respectively and also structured clinical interview, based on DSM-5 criteria in order to diagnose the major vascular neurocognitive disorder.

Results: Forty eight of the patients were diagnosed with PISD (prevalence 23.3%). Cox proportional hazards regression demonstrated that older age (hazard ratio [HR]=1.06,95%CI:1.00-1.11,P=0.035), lower educational level (HR=0.64,95%CI:0.44-0.94,P=0.021), more severe stroke (HR=1.21,95%CI:1.06-1.37,P=0.004),which was measured by National Institutes of Health Stroke Scale (NIHSS) and more premorbid cognitive impairment (HR=6.09,95%CI:2.34-15.87,P<0.0001) measured by Informant Questionnaire on Cognitive Decline in the elderly(IQCODE), prognosticates the risk of PISD diagnosis on an average of six-months after stroke.

Conclusion: PISD prevalence is remarkable among patients discharged from a hospital on a six month post stroke period. Early recognition of demographic factors related to PISD is helpful in more effective treatment, and can help prevent further loss of performance in stroke patients.