Neuroimaging predictors of death and dementia in a cohort of older stroke survivors

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Abstract

Background: Stroke is a risk factor for subsequent death and dementia. Being able to identify subjects at particular risk would be beneficial to inform treatment and patient management. Methods: Subjects aged over 75 years with incident stroke were recruited. Subjects had a cognitive assessment at 3 months post stroke to exclude dementia, and had an MRI scan (n=106) at that time. Subjects were then followed longitudinally for incident dementia and/or death. Results: Independent neuroimaging predictors of survival to dementia were medial temporal atrophy (MTA; p=0.013) and the presence of thalamic infarcts (p=0.002). After inclusion of cognitive score in the model, the significance of MTA (p=0.049) and thalamic infarcts (p=0.04) was reduced, with survival being best predicted by baseline cognitive score (p=0.004). The only independent significant predictor of survival to death was MTA. Apart from thalamic infarcts, the NINDS/ AIREN neuroimaging criteria did not independently predict survival to death or dementia. Conclusions: MTA was associated with shorter time to dementia, suggesting a role for Alzheimer pathology in the development of post stroke dementia.

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APA

Firbank, M. J., Allan, L. M., Burton, E. J., Barber, R., O’Brien, J. T., & Kalaria, R. N. (2012). Neuroimaging predictors of death and dementia in a cohort of older stroke survivors. Journal of Neurology, Neurosurgery and Psychiatry, 83(3), 263–267. https://doi.org/10.1136/jnnp-2011-300873

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