| アブストラクト | BACKGROUND: Prior atherosclerotic cardiovascular disease (ASCVD), including coronary heart disease (CHD) and peripheral artery disease (PAD), are common among patients with stroke, a known risk factor for dementia. However, whether these conditions further increase the risk of post-stroke dementia remains uncertain. OBJECTIVE: To examine whether prior ASCVD is associated with increased risk of dementia among stroke patients. METHODS: A retrospective cohort study was conducted using the Clinical Practice Research Datalink with linkage to hospital data. Patients with first-ever stroke between 2006 and 2017 were followed up to 10 years. We used multi-variable Cox regression models to examine the associations of prior ASCVD with dementia and the impact of prior ASCVD onset and duration. RESULTS: Among 63,959 patients, 7,265 cases (11.4%) developed post-stroke dementia during a median of 3.6-year follow-up. The hazard ratio (HR) of dementia adjusted for demographics and lifestyle was 1.18 (95% CI: 1.12-1.25) for ASCVD, 1.16 (1.10-1.23) for CHD, and 1.25 (1.13-1.37) for PAD. The HRs additionally adjusted for multimorbidity and medications were 1.07 (1.00-1.13), 1.04 (0.98-1.11), and 1.11 (1.00-1.22), respectively. Based on the fully adjusted estimates, there was no linear relationship between the age of ASCVD onset and post-stroke dementia (all p-trend >0.05). The adjusted risk of dementia was not increased with the duration of pre-stroke ASCVD (all p-trend >0.05). CONCLUSION: Stroke patients with prior ASCVD are more likely to develop subsequent dementia. After full adjustment for confounding, however, the risk of post-stroke dementia is attenuated, with only a slight increase with prior ASCVD. |
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| ジャーナル名 | Journal of Alzheimer's disease : JAD |
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| 投稿日 | 2020/9/15 |
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| 投稿者 | Yang, Zhirong; Edwards, Duncan; Burgess, Stephen; Brayne, Carol; Mant, Jonathan |
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| 組織名 | Primary Care Unit, Department of Public Health and Primary Care, School of;Clinical Medicine, University of Cambridge, Cambridge, UK.;MRC Biostatistics Unit, School of Clinical Medicine, University of Cambridge,;Cambridge, UK.;Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care,;School of Clinical Medicine, University of Cambridge, Cambridge, UK.;Institute of Public Health, School of Clinical Medicine, University of Cambridge, |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/32925051/ |
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