Dementia as a predictor of adverse outcomes following stroke: an evaluation of diagnostic methods

Stroke; a Journal of Cerebral Circulation
D W DesmondY Stern

Abstract

Although it is understood that dementia is a risk factor for adverse outcomes, little is known about the predictive validity of the numerous methods that have been proposed for its diagnosis. Thus, we performed the present study to assess the utility of a variety of diagnostic methods in the prediction of adverse outcomes following stroke. We administered neuropsychological, neurological, and functional examinations to 244 patients (age, 71.7+/-8.5 years) 3 months after ischemic stroke. We diagnosed dementia using each of the following methods: (1) neuropsychological testing, requiring deficits in increasing numbers of cognitive domains, both with and without memory impairment, as well as functional impairment; (2) Mini-Mental State Examination (MMSE) score of <24; and (3) neurologists' clinical judgment. We then used survival analyses to investigate the ability of diagnoses based on those methods to predict death and recurrent stroke during long-term follow-up. Log-rank tests and Cox proportional hazards analyses, with recurrent stroke entered as a time dependent covariate, determined that all of the paradigms were significant predictors of mortality, but the performance of paradigms based on neuropsychological testing was sup...Continue Reading

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Citations

Oct 31, 2002·Human Psychopharmacology·Kurt Heininger
May 2, 2002·Journal of the American Geriatrics Society·Mehool D PatelCharles D A Wolfe
Oct 31, 2003·Archives of Physical Medicine and Rehabilitation·Jacqueline B HochstenbachTheo W Mulder
Oct 3, 2003·Topics in Stroke Rehabilitation·Lori A Shutter, Jon Erik Ween
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Feb 2, 2017·International Journal of Geriatric Psychiatry·Mark B SnowdenAnnette L Fitzpatrick
Dec 6, 2005·Cerebrovascular Diseases·Gustavo C Román
Mar 11, 2003·Clinical Rehabilitation·Mehool PatelCharles D A Wolfe
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Jan 11, 2002·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·S MadureiraJ M Ferro
Nov 14, 2019·Journal of Neurology·Hyuk Sung KwonUNKNOWN PICASSO investigators

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