University of Exeter Medical School, St Luke's Campus, Exeter, UK.
Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA; Department of Neurology and Stroke Program, University of Michigan, Ann Arbor, MI, USA.
Alzheimers Dement. 2018 Nov;14(11):1416-1426. doi: 10.1016/j.jalz.2018.06.3061. Epub 2018 Aug 31.
Stroke is an established risk factor for all-cause dementia, though meta-analyses are needed to quantify this risk.
We searched Medline, PsycINFO, and Embase for studies assessing prevalent or incident stroke versus a no-stroke comparison group and the risk of all-cause dementia. Random effects meta-analysis was used to pool adjusted estimates across studies, and meta-regression was used to investigate potential effect modifiers.
We identified 36 studies of prevalent stroke (1.9 million participants) and 12 studies of incident stroke (1.3 million participants). For prevalent stroke, the pooled hazard ratio for all-cause dementia was 1.69 (95% confidence interval: 1.49-1.92; P < .00001; I = 87%). For incident stroke, the pooled risk ratio was 2.18 (95% confidence interval: 1.90-2.50; P < .00001; I = 88%). Study characteristics did not modify these associations, with the exception of sex which explained 50.2% of between-study heterogeneity for prevalent stroke.
Stroke is a strong, independent, and potentially modifiable risk factor for all-cause dementia.
中风是导致全因痴呆的既定危险因素，但需要进行荟萃分析来量化这种风险。
我们在 Medline、PsycINFO 和 Embase 中搜索了评估现患或新发中风与无中风对照组以及全因痴呆风险的研究。我们使用随机效应荟萃分析来汇总研究间的调整估计值，并使用元回归来研究潜在的效应修饰剂。
我们确定了 36 项现患中风研究（190 万参与者）和 12 项新发中风研究（130 万参与者）。对于现患中风，全因痴呆的合并危险比为 1.69（95%置信区间：1.49-1.92；P<0.00001；I=87%）。对于新发中风，合并风险比为 2.18（95%置信区间：1.90-2.50；P<0.00001；I=88%）。研究特征并未改变这些关联，除了性别，其解释了现患中风研究间异质性的 50.2%。
中风是全因痴呆的一个强烈、独立且潜在可改变的危险因素。
