Do Silent Brain Infarctions Predict the Development of Dementia After First Ischemic Stroke?
Keywords:silent infarcts, dementia, ischemic stroke, vascular risk factors, cognitive decline.
Background: Silent brain infarctions (SBI) are common findings in advanced age, but their relationship to dementia is still uncertain.
Aim: The present study was designed to evaluate whether SBI predict the development of dementia after first clinical ischemic stroke.
Methods: We blindly studied admission CT scans of 102 consecutive nondemented patients presenting with ischemic stroke that clinically was their first stroke episode. SBI were defined as CT evidence of infarcts not compatible with the acute event. The patients were subsequently followed for their mental state for 2 years. Survival analysis, wherein onset of dementia was the end point, was performed on the total sample population and conducted separately on those with and without SBI at admission.
Results: Dementia developed in 33 patients (32.3%), including 17 of the 37 (45.9%) with SBI and 16 of the 65 (24.6%) without SBI. Thus, dementia was strong related to SBI.Conclusion: Elderly people with silent brain infarcts and stroke have an increased risk of dementia and a steeper decline in cognitive function than those without such lesions.
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