Abstract Body: Background: Post-stroke dementia (PSD) is a common sequela associated with detrimental effects on the quality of life of stroke survivors after stroke. However, the long-term incidence of PSD after an ischemic stroke and its risk factors, including medication and acute stroke management, are not well established. Therefore, this study aimed to investigate the longitudinal incidence of PSD and identify the factors associated with PSD after ischemic stroke in patients without a history of dementia using a linked dataset in Korea.
Methods: From January 2008 to December 2014, patients with ischemic stroke (n = 37,553) without a history of dementia were included in a linked dataset comprising the claims database of the Health Insurance Review and Assessment Service and the Clinical Research Center for Stroke registry data. The outcome measure was PSD after ischemic stroke. Clinical factors related to the development of PSD following ischemic stroke, including vascular risk factors, acute stroke management, and educational levels, were evaluated.
Results: Among 37,553 patients with ischemic stroke (mean age 64.9 years, 61.9% male), 6, 052 (16.1 %) experienced PSD following ischemic stroke. The estimated cumulative incidence of dementia by 10 years was found to be 23.5%. Age, female sex, and a lower educational level were associated with an increased PSD risk. Vascular risk factors were identified as independent risk factors for PSD. Regarding stroke management, the use of antithrombotic and antipsychotic medications was associated with an increased risk of PSD.
Conclusions: The incidence of PSD in patients with ischemic stroke without a history of dementia varied depending on clinical characteristics, including age, sex, risk factors, and medications. Early identification of patients at a higher risk of PSD could help decide plans for long-term care and improve outcomes after ischemic stroke.