Zhou David H D, Wang John Y J, Li Jingcheng, Deng Juan, Gao Changyue, Chen Man'e
2nd Dept. of Neurology, Daping Hospital, 3rd Military Medical University, Chongqing, China.
J Neurol. 2004 Apr;251(4):421-7. doi: 10.1007/s00415-004-0337-z.
We studied a large hospitalized cohort of patients aged 55 years and over with acute ischemic stroke to identify the frequency and predictors of poststroke dementia.
A total of 434 consecutive patients with ischemic stroke were enrolled in this study. During admission, the demographic data, vascular risk factors, stroke features, and neurological status information were collected. All subjects were examined by a battery of neuropsychological tests during admission and 3 months after stroke. Logistic regression analysis was used to find the predictors of poststroke dementia.
(1) The frequency of poststroke dementia was 27.2%, that of stroke-related dementia was 21.6%, and that of dementia after first-ever stroke was 22.7% 3 months after stroke. (2) Univariate analysis indicated that older age, low educational level (<or=6 years), everyday drinking, diabetes mellitus, atrial fibrillation, prior stroke, left carotid territory infarction, embolism, multiple stroke lesions, dysphasia, and gait impairment were more frequent in the patients with poststroke dementia. (3) Multivariate analyses demonstrated that age (OR 1.179, 95%CI 1.130-1.230), low educational level (OR 1.806, 95 %CI 1.024-3.186), everyday drinking (OR 3.447, 95 %CI 1.591-7.468), prior stroke (OR 2.531, 95 %CI 1.419-4.512), atrial fibrillation (OR 3.475, 95%CI 1.712-7.057), dysphasia (OR 5.873, 95 %CI 2.620-13.163), and left carotid territory infarction (OR 1.975, 95%CI 1.152-3.388) were associated with poststroke dementia.
The frequency of dementia is about one-forth of patients with ischemic stroke 3 months after stroke. Independent predictors of poststroke dementia include age, low educational level, everyday drinking, prior stroke, dysphasia, atrial fibrillation, and left carotid territory infarction.
我们研究了一个年龄在55岁及以上的急性缺血性中风住院患者大队列，以确定中风后痴呆的发生率及预测因素。
本研究共纳入434例连续的缺血性中风患者。入院期间，收集人口统计学数据、血管危险因素、中风特征及神经学状态信息。所有受试者在入院时及中风后3个月接受一系列神经心理学测试。采用逻辑回归分析来寻找中风后痴呆的预测因素。
（1）中风后痴呆的发生率为27.2%，中风相关性痴呆的发生率为21.6%，首次中风后3个月痴呆的发生率为22.7%。（2）单因素分析表明，年龄较大、教育水平低（≤6年）、每日饮酒、糖尿病、心房颤动、既往中风、左侧颈动脉供血区梗死、栓塞、多发中风病灶、言语困难及步态障碍在中风后痴呆患者中更为常见。（3）多因素分析显示，年龄（比值比1.179，95%可信区间1.130 - 1.230）、教育水平低（比值比1.806，95%可信区间1.024 - 3.186）、每日饮酒（比值比3.447，95%可信区间1.591 - 7.468）、既往中风（比值比2.531，95%可信区间1.419 - 4.512）、心房颤动（比值比3.475，95%可信区间1.712 - 7.057）、言语困难（比值比5.873，95%可信区间2.620 - 13.163）及左侧颈动脉供血区梗死（比值比1.975，95%可信区间1.152 - 3.388）与中风后痴呆相关。
中风后3个月痴呆的发生率约为缺血性中风患者的四分之一。中风后痴呆的独立预测因素包括年龄、教育水平低、每日饮酒、既往中风、言语困难、心房颤动及左侧颈动脉供血区梗死。
