Atherosclerosis may up the risk for post-stroke dementia

  • Yang Z & al.
  • Ageing Res Rev
  • 7 Sep 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Limited evidence suggests that existing atherosclerotic disease manifested by coronary heart disease (CHD), peripheral artery disease (PAD) and carotid stenosis (CS) may be associated with an increased risk for post-stroke dementia and cognitive impairment.
  • Post-stroke statin use was associated with a decreased risk for cognitive impairment.

Why this matters

  • Finding suggests that atherosclerosis may be an important risk factor for post-stroke cognitive impairment and dementia.
  • Statins may lower the risk of post-stroke cognitive decline.

Study design

  • 56 studies including 38,423 patients with stroke met eligibility criteria.
  • Primary outcome: any dementia, cognitive impairment and mild cognitive impairment/cognitive impairment no dementia (MCI/CIND).
  • Funding: The National Institute for Health Research (NIHR) School of Primary Care Research.

Key results

  • The pooled OR for dementia and cognitive impairment, respectively, was:
  • For CHD:
    • 1.32; 95% CI, 1.11-1.58; P=.002 and
    • 1.23; 95% CI, 0.99-1.54; P=.066.
  • For PAD:
    • 3.59; 95% CI, 1.47-8.76; P=.005 and
    • 2.70; 95% CI, 1.09-6.69; P=.032.
  • For CS:
    • 2.67; 95% CI, 0.83-8.63; I2=77.9%; P=.099 and
    • 3.34; 95% CI, 0.79-14.1; I2=96.6%; P=.101.
  • Post-stroke statin use was associated with a decreased risk for dementia (OR, 0.89; 95% CI, 0.65-1.21; P=.440) and cognitive impairment (OR, 0.56; 95% CI, 0.46-0.69; P<.001>
  • Hypercholesterolemia was not associated with dementia and cognitive impairment.

Limitations

  • Publication bias.
  • Heterogeneity among included studies.