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. 2012 Mar;83(3):263-7.
doi: 10.1136/jnnp-2011-300873. Epub 2011 Nov 23.

Neuroimaging predictors of death and dementia in a cohort of older stroke survivors

Michael J Firbank  1 , Louise M Allan, Emma J Burton, Robert Barber, John T O'Brien, Raj N Kalaria
Affiliations

Neuroimaging predictors of death and dementia in a cohort of older stroke survivors

Michael J Firbank et al. J Neurol Neurosurg Psychiatry. 2012 Mar.

Abstract

Background: Stroke is a risk factor for subsequent death and dementia. Being able to identify subjects at particular risk would be beneficial to inform treatment and patient management.

Methods subjects: aged over 75 years with incident stroke were recruited. Subjects had a cognitive assessment at 3 months post stroke to exclude dementia, and had an MRI scan (n=106) at that time. Subjects were then followed longitudinally for incident dementia and/or death.

Results: Independent neuroimaging predictors of survival to dementia were medial temporal atrophy (MTA; p=0.013) and the presence of thalamic infarcts (p=0.002). After inclusion of cognitive score in the model, the significance of MTA (p=0.049) and thalamic infarcts (p=0.04) was reduced, with survival being best predicted by baseline cognitive score (p=0.004). The only independent significant predictor of survival to death was MTA. Apart from thalamic infarcts, the NINDS/AIREN neuroimaging criteria did not independently predict survival to death or dementia.

Conclusions: MTA was associated with shorter time to dementia, suggesting a role for Alzheimer pathology in the development of post stroke dementia.

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Conflict of interest statement

Competing interests: RNK has received speaker honoraria from Pfizer Inc. JTO has been a consultant for GE Healthcare, Servier and Bayer Healthcare, and has received honoraria for talks from Pfizer, GE Healthcare, Eisai, Shire, Lundbeck, Lilly and Novartis.

Figures

Figure 1
Figure 1
Univariate survival. (A) Time to dementia by Cambridge Cognitive Assessment-revised (CAMCOG-R) score in three groups—CAMCOG-R >90 (n=31), CAMCOG-R 82–90 (n=38) and CAMCOG-R <82 (n=37). (B) Time to death by medial temporal atrophy (MTA) in two groups—MTA <3 (n=50) and MTA ≥3 (n=56).
See this image and copyright information in PMC

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