Droś Jakub, Klimkowicz-Mrowiec Aleksandra
Doctoral School in Medical and Health Sciences, Jagiellonian University Medical College, Kraków, Poland.
Department of Internal Medicine and Gerontology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland.
Psychogeriatrics. 2021 May;21(3):407-417. doi: 10.1111/psyg.12666. Epub 2021 Feb 19.
Dementia is one of the leading complications after stroke affecting about one third of survivors. Prevalence of post-stroke dementia (PSD) differs between studies due to variability in methodology, characteristics of included patients, type of stroke, diagnostic tools used to identify patients with dementia, or time when the assessment was performed. Patients diagnosed with PSD are at higher risk of mortality, disability, and institutionalization. Aetiology of PSD may include mixed overlapping processes such as vascular brain pathology or Alzheimer's disease. Several risk factors have been found to increase PSD incidence, involving demographics, vascular factors, stroke characteristics, abnormalities on neuroimaging, and stroke complications. However, the influence of some other factors still remains unclear. PSD may coexist with other neuropsychiatric disorders and its association with post-stroke depression seems to be the most significant. There is a strong need for further research on possible genetic, biological, and inflammatory biomarkers. Also, there are no unambiguously efficacious methods of management. Continuing to address these issues will help to find more effective interventions directly targeting prevention and treatment of PSD in the future.
痴呆是中风后主要的并发症之一,约三分之一的幸存者会受到影响。由于研究方法、纳入患者的特征、中风类型、用于识别痴呆患者的诊断工具或评估时间的差异,中风后痴呆(PSD)的患病率在不同研究中有所不同。被诊断为PSD的患者死亡、残疾和入住机构的风险更高。PSD的病因可能包括血管性脑病变或阿尔茨海默病等混合重叠过程。已发现若干风险因素会增加PSD的发病率,涉及人口统计学、血管因素、中风特征、神经影像学异常和中风并发症。然而,其他一些因素的影响仍不明确。PSD可能与其他神经精神障碍共存,其与中风后抑郁的关联似乎最为显著。迫切需要对可能的遗传、生物学和炎症生物标志物进行进一步研究。此外,目前尚无明确有效的管理方法。继续解决这些问题将有助于在未来找到更直接针对PSD预防和治疗的有效干预措施。