Sex differences in predictors for cognitive decline and dementia in people with stroke or transient ischemic attack in the PROGRESS trial
| dc.rights.license | open | en_US |
| dc.contributor.author | GONG, Jessica | |
| dc.contributor.author | HARRIS, Katie | |
| hal.structure.identifier | Bordeaux population health [BPH] | |
| dc.contributor.author | TZOURIO, Christophe | |
| dc.contributor.author | HARRAP, Stephen | |
| dc.contributor.author | NAISMITH, Sharon | |
| dc.contributor.author | ANDERSON, Craig S. | |
| dc.contributor.author | CHALMERS, John | |
| dc.contributor.author | WOODWARD, Mark | |
| dc.date.accessioned | 2022-01-14T09:38:50Z | |
| dc.date.available | 2022-01-14T09:38:50Z | |
| dc.date.issued | 2021-11-18 | |
| dc.identifier.issn | 1747-4949 (Electronic) 1747-4930 (Linking) | en_US |
| dc.identifier.uri | https://oskar-bordeaux.fr/handle/20.500.12278/124387 | |
| dc.description.abstractEn | BACKGROUND: Stroke and transient ischemic attack confer greater risk of cognitive decline and dementia. AIMS: We used data from the Perindopril Protection Against Recurrent Stroke Study (PROGRESS), a blood pressure-lowering randomized controlled trial in stroke/transient ischemic attack. We evaluated overall and sex-specific differences in treatment effects for cognitive decline/dementia, as well as associations with vascular and stroke-specific predictors,considering death as a competing risk. METHODS: Multinomial logistic regression was used to estimate overall and sex-specific odds ratios (OR) (95% confidence intervals (CI)) for treatment effects and predictors associated with the risk of cognitive decline/dementia, and the women-to-men ratio of odds ratio (RORs). RESULTS: Over a median four years, 763 cognitive decline/dementia (30.9% women) were recorded in 5888 participants. Women had lower odds of cognitive decline/dementia than men (OR 0.78, 95%CI 0.63-0.95). Active treatment was associated with lower odds of cognitive decline/dementia (0.84, 0.72-0.98), with no evidence of sex difference. Higher education (0.96,0.94-0.98 (per year)) and baseline Mini-Mental State Examination (MMSE)) were associated with lower odds of cognitive decline/dementia (0.84,0.82-0.86 (per point higher)). Higher diastolic blood pressure (1.11,1.02-1.20 (per 10 mmHg)), low estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m(2) (1.27,1.03-1.58), and peripheral arterial disease (1.78,1.26-2.52) were associated with higher odds of cognitive decline/dementia. APOE varepsilon4 was not associated with cognitive decline/dementia (1.05 (0.85-1.30)). Low eGFR was more strongly associated with cognitive decline/dementia in women than men (RORs, 1.60 (1.03-2.48)). Diabetes was more strongly associated with men than women. CONCLUSIONS: Several risk factors were associated with cognitive decline/dementia in people with prior stroke/transient ischemic attack, with notable sex differences. Long-term cognitive sequelae of stroke should be considered to strengthen joint prevention strategies for stroke, cognitive decline, and dementia.Trial Registration: This trial was not registered because enrolment began before 1 July 2005. | |
| dc.language.iso | EN | en_US |
| dc.subject.en | Stroke | |
| dc.subject.en | Dementia | |
| dc.subject.en | Cognitive decline | |
| dc.subject.en | Sex difference | |
| dc.subject.en | Competing risk | |
| dc.title.en | Sex differences in predictors for cognitive decline and dementia in people with stroke or transient ischemic attack in the PROGRESS trial | |
| dc.type | Article de revue | en_US |
| dc.identifier.doi | 10.1177/17474930211059298 | en_US |
| dc.subject.hal | Sciences du Vivant [q-bio]/Santé publique et épidémiologie | en_US |
| dc.identifier.pubmed | 34791978 | en_US |
| bordeaux.journal | International Journal of Stroke | en_US |
| bordeaux.hal.laboratories | Bordeaux Population Health Research Center (BPH) - UMR 1219 | en_US |
| bordeaux.institution | Université de Bordeaux | en_US |
| bordeaux.institution | INSERM | en_US |
| bordeaux.team | HEALTHY_BPH | en_US |
| bordeaux.peerReviewed | oui | en_US |
| bordeaux.inpress | non | en_US |
| hal.identifier | hal-03525912 | |
| hal.version | 1 | |
| hal.date.transferred | 2022-01-14T09:38:52Z | |
| hal.export | true | |
| dc.rights.cc | Pas de Licence CC | en_US |
| bordeaux.COinS | ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=International%20Journal%20of%20Stroke&rft.date=2021-11-18&rft.eissn=1747-4949%20(Electronic)%201747-4930%20(Linking)&rft.issn=1747-4949%20(Electronic)%201747-4930%20(Linking)&rft.au=GONG,%20Jessica&HARRIS,%20Katie&TZOURIO,%20Christophe&HARRAP,%20Stephen&NAISMITH,%20Sharon&rft.genre=article |
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