Preexisting Dementia in Stroke Patients Ups Disability

Dementia patients are older, have more severe strokes, are more likely to have atrial fibrillation

MONDAY, Oct. 31 (HealthDay News) -- For patients with stroke, preexisting dementia is associated with increased disability at discharge and lower likelihood of being discharged to prestroke domicile, according to a study published in the Nov. 1 issue of Neurology.

Gustavo Saposnik, M.D., from the University of Toronto, and colleagues described the clinical characteristics, processes of care, and outcomes at discharge in 9,304 patients presenting with an ischemic stroke between 2003 and 2008. Of the patients, 702 had a history of dementia. Demographic information, clinical presentation, selected process measures (thrombolysis, admission to a stroke unit, carotid imaging, stroke prevention), pneumonia, death, disability, and disposition at discharge were assessed.

The investigators found that, compared to patients without dementia, those with dementia were significantly older, had strokes which were significantly more severe, and were significantly more likely to have atrial fibrillation. The likelihood of being admitted to a stroke unit or to receive thrombolysis was less in patients with dementia (odds ratio [OR], 0.82 and 0.63, respectively). No differences were found in other performances measures. Higher disability at discharge (OR, 3.20) was seen in patients with preexisting dementia, and they were significantly less likely to be discharged to their prestroke place of residence (24 versus 45 percent).

"These findings highlight the frailty of stroke patients with preexisting dementia and their poor clinical recovery," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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