One-year survival of demented stroke patients: data from the Dijon Stroke Registry, France (1985-2008)

• Published in: European journal of neurology Vol. 19; no. 5; pp. 712 - 717
• Main Authors: Béjot, Y., Jacquin, A., Rouaud, O., Durier, J., Aboa-Eboulé, C., Hervieu, M., Osseby, G.-V., Giroud, M.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.05.2012; John Wiley & Sons, Inc
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; Analysis of Variance; Data processing; dementia; Dementia - epidemiology; Dementia - mortality; Dementia disorders; epidemiology; Fatalities; Female; Follow-Up Studies; France - epidemiology; Geriatrics; Humans; Male; Medical prognosis; Middle Aged; mortality; Multivariate analysis; Neuropsychological Tests; outcome; Prognosis; Registries - statistics & numerical data; Retrospective Studies; Risk Factors; Stroke; Stroke - complications; Stroke - epidemiology; Stroke - mortality; subarachnoid hemorrhage; Survival; Survival Rate; Time Factors; France
• ISSN: 1351-5101; 1468-1331
• DOI: 10.1111/j.1468-1331.2011.03613.x

Background and purpose:  Dementia is a frequent condition after stroke that may affect the prognosis of patients. Our aim was to determine whether post‐stroke dementia was a predictor of 1‐year case‐fatality and to evaluate factors that could influence survival in demented stroke patients. Methods:  From 1985 to 2008, all first‐ever strokes were recorded in the population‐based stroke registry of Dijon, France (150 000 inhabitants). Dementia was diagnosed during the first month following stroke, according to DSM‐III and DSM‐IV criteria. Survival was evaluated at 1 year and multivariate analyses were performed using Cox proportional hazards to identify independent predictive factors. Results:  We recorded 3948 first‐ever strokes. Among these stroke patients, 3201 (81%) were testable, and of these, 653 (20.4%) had post‐stroke dementia (337 women and 316 men). Demented patients had lower 1‐year survival than patients without dementia (82.9% vs. 86.9%, P = 0.013). However, in multivariate analysis, dementia did not appear as an independent predictor of 1‐year death. In demented stroke patients, age >80 years old, severe handicap at discharge, recurrent stroke within the first year and subarachnoid haemorrhage were associated with a higher risk of 1‐year death, and the risk was lower in the study period 2003–2008. Conclusions:  Dementia after stroke is not independently associated with an increased risk of death at 1 year. In recent years, 1‐year case‐fatality decreased in demented as well as in and non‐demented patients suggesting that improvements in the management of stroke also benefited the most fragile patients.