Risk factors for dementia and cognitive impairment within 5 years after stroke: a prospective multicentre cohort study
Abstract
Summary Background Stroke survivors frequently experience subsequent cognitive impairment or dementia. We aimed to identify risk factors for post-stroke dementia (PSD) and cognitive impairment (PSCI) within 5 years after stroke. Methods The DEMDAS (German Center for Neurological Diseases (DZNE) mechanisms of dementia after stroke) study is a prospective cohort of stroke patients admitted to six German tertiary stroke centres between May 1, 2011 and January 31, 2019. Eligible dementia-free patients with ischaemic or haemorrhagic stroke underwent baseline examinations and regular clinical, neuropsychological, and neuroimaging follow-ups over 5 years, with the last follow-ups completed in January 2024. PSD was the primary outcome, determined by comprehensive cognitive testing, patient and informant interviews, and review of medical records. The secondary outcomes were early-onset PSD (3–6 months), delayed-onset PSD (>6 months), and PSCI. Associations between baseline risk factors and PSD were assessed using Cox regression models adjusted for age, sex, education, and stroke severity. Findings Of 736 patients (245 [33%] female, mean age 68·0 years [SD 11·2], median admission National Institutes of Health Stroke Scale (NIHSS) 3 [IQR 1–5]), 557 (76%) were followed up until death or the end of the study, and 706 (96%) contributed to the PSD analysis. During a median of 5·0 years [IQR 3·3–5·1] of follow-up, 55 new dementia cases were diagnosed (6-month incidence: 3·1% [1·8–4·5],…
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