You are not logged in. Press here to login.

Content

List volumes - List articles in this issue

Original report

Stroke rehabilitation is associated with a reduction in dementia risk: A population-based retrospective cohort study

doi: 10.2340/16501977-0935

Open access

Abstract:

OBJECTIVE: Focusing on the relationship between physical activity and incident cognitive impairment, the aim of this study was to investigate whether stroke rehabilitation reduces the risk of dementia.
METHODS: Claims data of 1,000,000 insured subjects randomly selected from the National Health Insurance programme of Taiwan were used to identify adults with a newly diagnosed ischaemic stroke in 1997–2002. Among them, 1,375 received rehabilitation and 3,722 did not. Both groups were followed up until the end of 2007 to measure the incidence of development of dementia.
RESULTS: The incidence of development of dementia was lower in the rehabilitation cohort than in the non-rehabilitation cohort (1.22 vs 1.70 per 100 person-years), with an adjusted hazard ratio (HR) of 0.73 (95% confidence interval (CI) = 0.60–0.89) in the multivariate Cox proportional hazard regression analysis. Female gender (HR = 1.26, 95% CI = 1.07–1.50), older age (HR = 7.71, 95% CI = 3.36–17.7), low income (HR = 1.82, 95% CI = 1.42–2.33), and Parkinson’s disease (HR = 1.64, 95% CI = 1.33–2.03) were risk factors associated with the development of dementia.
CONCLUSION: Post-stroke rehabilitation is associated with a reduction in dementia risk among ischaemic stroke patients.

Authors:

Yi-Chun Chou, Chien-Chang Liao , Li-Ting Su , Pei-Yu Yang, Fung-Chang Sung

References

  1. Zhu L, Fratiglioni L, Guo Z, Aguero-Torres H, Winblad B, Viitanen M. Associated of stroke with dementia, cognitive impairment, and functional disability in the very old: a population-based study. Stroke 1998; 29: 2094–2099.
  2. Zhu L, Fratiglioni L, Guo Z, Winblad B, Viitanen M. Incidence of stroke in relation to cognitive function and dementia in the Kungsholmen Project. Neurology 2000; 54: 2103–2107.
  3. Savva GM, Stephan BCM. Epidemiological studies of the effect of stroke on incident dementia: a systematic review. Stroke 2010; 41: e41–e46.
  4. Leys D, Henon H, Mackowiak-Cordoliani MA, Pasquier F. Poststroke dementia. Lancet Neurol 2005; 4: 752–759.
  5. Desmond DW, Moroney JT, Sano M, Stern Y. Incidence of dementia after ischemic stroke: results of a longitudinal study. Stroke 2002; 33: 2254–2262.
  6. Melkas S, Okasala NK, Jokinen H, Pohjasvaara T, Vataja R, Oksala A, et al. Poststroke dementia predicts poor survival in long-term follow-up: influence of prestroke cognitive decline and previous stroke. J Neurol Neurosurg Psychiatry 2009; 80: 865–870.
  7. Kemoun G, Thibaud M, Roumagne N, Carette P, Albinet C, Toussaint L, et al. Effects of a physical training programme on cognitive function and walking efficiency in elderly persons with dementia. Dement Geriatr Cogn Disord 2010; 29: 109–114.
  8. Etgen T, Sander D, Huntqeburth U, Poppert H, Forsti H, Bickel H. Physical activity and incident cognitive impairment in elderly persons: the INVADE study. Arch Intern Med 2010; 170: 186–193.
  9. Verghese J, Lipton RB, Katz MJ, Hall CB, Derby CA, Kuslansky G, et al. Leisure activities and the risk of dementia in the elderly. N Engl J Med 2003; 348: 2508–2516.
  10. Gordon NF, Gulanick M, Costa F, Fletcher G, Franklin BA, Roth EJ, et al. Physical activity and exercise recommendations for stroke survivors. Circulation 2004; 109: 2031–2041.
  11. Verdelho A, Hénon H, Lebert F, Pasquier F, Leys D. Depressive symptoms after stroke and relationship with dementia: a three-year follow-up study. Neurology 2004; 62: 905–911.
  12. Jorm AF, Korten AE, Henderson AS. The prevalence of dementia: a quantitative integration of the literature. Acta Psychiatr Scand 1987; 76: 465–479.
  13. Liu HC, Lin KN, Teng EL, Wang SJ, Fuh JL, Guo NW, et al. Prevalence and subtypes of dementia in Taiwan: a community survey of 5297 individuals. J Am Geriatr Soc 1995; 43: 144–149.
  14. Liu CK, Lin RT, Chen YF, Tai CT, Yen YY, Howng SL. Prevalence of dementia in an urban area in Taiwan. J Formos Med Assoc 1996; 95: 762–768.
  15. Chen HF, Lee SP, Li CY. Sex differences in the incidence of hemorrhagic and ischemic stroke among diabetics in Taiwan. J Womens Health (Larchmt) 2009; 18: 647–654.
  16. Ivan CS, Seshadri S, Beiser A, Au R, Kase CS, Kelly-Hayes M, et al. Dementia after stroke: the Framingham study. Stroke 2004; 35: 1264–1269.
  17. Kokmen E, Whisnant JP, O'Fallon WM, Chu CP, Beard CM. Dementia after ischemic stroke: a population-based study in Rochester, Minnesota (1960–1984). Neurology 1996; 46: 154–159.
  18. Weintraub D, Comella CL, Horn S. Parkinson’s disease – part 3: neuropsychiatric symptoms. Am J Manag Care 2008; 14: S59–S69.
  19. Graham JE, Rockwood K, Beattie BL, Eastwood R, Gauthier S, Tuokko H, et al. Prevalence and severity of cognitive impairment with and without dementia in an elderly population. Lancet 1997; 349: 1793–1796.
  20. Luck T, Riedel-Heller SG, Kaduszkiewicz H, Bickel H, Jessen F, Pentzek M, et al. Mild cognitive impairment in general practice: age-specific prevalence and correlate results from the German study on ageing, cognition and dementia in primary care patients (AgeCoDe). Dement Geriatr Cogn Disord 2007; 24: 307–316.
  21. Abbott RD, White LR, Ross GW, Masaki KH, Curb JD, Petrovitch H. Walking and dementia in physically capable elderly men. JAMA 2004; 292: 1447–1453.
  22. Weuve J, Kang JH, Manson JE, Breteler MM, Ware JH, Grodstein F. Physical activity, including walking, and cognitive function in older women. JAMA 2004; 292: 1454–1461.
  23. Slooter AJC, Tang MX, van Duijn CM, Stern Y, Ott A, Bell K, et al. Apolipoprotein E-4 and the risk of dementia with stroke: a population-based investigation. JAMA 1997; 277: 818–821.
  24. Joutel A, Corpechot C, Ducros A, Vahedi K, Chabriat H, Mouton P, et al. Notch3 mutations in CADASIL, a hereditary adult-onset condition causing stroke and dementia. Nature 1996; 383: 707–710.
  25. Desmond DW, Moroney JT, Lynch T, Chan S, Chin SS, Shungu DC, et al. CADASIL in a North American family: clinical, pathologic, and radiologic findings. Neurology 1998; 5: 844–849.


Related articles

There are no related articles.


Actions


Abstract

Full text

PDF

Supplementary


There is no supplementary for this article.

Related articles


Click here to show related articles

Print information


Volume 44, Issue 4

DOI: 10.2340/16501977-0935

Pages: 319-324

View at PubMed