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Risk Of Dementia Following First-ever Hemorrhagic Or Ischemic Stroke In The General Population

dc.rights.licenseopenen_US
dc.contributor.authorWAZIRY, Reem
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorDUFOUIL, Carole
dc.contributor.authorHOFMAN, Albert
dc.contributor.authorIKRAM, Kamran
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorSTEPHANIE, Debette
dc.contributor.authorWOLTERS, Frank J.
dc.contributor.authorFANI, Lana
dc.contributor.authorROMERO, Rafael J.
dc.contributor.authorAPARICIO, Hugo J.
dc.contributor.authorLIOUTAS, Vasileios
dc.contributor.authorVISWANATHAN, Anand
dc.contributor.authorSULLIVAN, Kevin
dc.contributor.authorGOUDSMIT, Jaap
dc.contributor.authorSESHARDI, Sudha
dc.contributor.authorIKRAM, Mohammad A.
dc.date.accessioned2022-06-15T07:52:39Z
dc.date.available2022-06-15T07:52:39Z
dc.date.issued2022-02
dc.identifier.issn0039-2499en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/140221
dc.description.abstractEnObjective: To assess risk of dementia after first-ever hemorrhagic or ischemic strokes in three prospective cohort studies (Three City, Framingham Heart Study and Rotterdam Study). Methods: Prospective data on incident hemorrhagic or ischemic strokes and matched stroke free comparison was used for each stroke subtype. 5-year risk of dementia after hemorrhagic or ischemic stroke was assessed using a matched case-cohort design. A random effects meta-analysis was used to combine hazard ratios for each study and variations in risk stratified by APOE ε4 allele were assessed. A direct comparison of risk of dementia after hemorrhagic compared with ischemic strokes was evaluated. In a sensitivity analysis Fine & Gray models were conducted after adjusting for competing deaths and subdistribution hazard ratios were computed. Pre-event and post-event cumulative incidence of dementia at 3, 6, 12, 24, 36 and 60 months were assessed. Results: A total of 4,922 persons, including 247 incident hemorrhagic strokes and 1,427 ischemic strokes were included. The combined hazard ratios of dementia were 2.78 (95% CI 1.28, 6.03) after hemorrhagic and 3.35 (1.51, 7.43) after ischemic stroke compared to stroke free individuals. The combined risk of dementia was 0.71 (0.14, 3.68) after hemorrhagic compared with ischemic stroke. Among individuals with APOE ε4 allele, the risk of dementia was 3.88 (1.16, 12.98) after hemorrhagic stroke and 2.10 (1.28, 3.42) after ischemic stroke compared to stroke-free individuals. The cumulative incidence post-event for hemorrhagic strokes flattened between 6 and 24 months with slight increase thereafter, in-contrast to a steady increase in dementia risk over time after ischemic strokes. Conclusions: No difference was observed in overall 5-year risk of dementia after hemorrhagic or ischemic stroke, while the risk was about 3 times higher compared to stroke-free individuals of similar risk profiles. APOE ε4 allele doubles the risk of dementia among hemorrhagic stroke survivors. Risk of dementia after ischemic stroke follows a stepwise pattern overtime, in contrast, dementia risk after hemorrhagic stroke is highest in the early phase.
dc.language.isoENen_US
dc.subject.enCerebrovascular disorders
dc.subject.enCognitive impairment
dc.subject.enAging
dc.subject.enBrain Health
dc.title.enRisk Of Dementia Following First-ever Hemorrhagic Or Ischemic Stroke In The General Population
dc.typeArticle de revueen_US
dc.identifier.doi10.1161/str.53.suppl_1.72en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
bordeaux.journalStrokeen_US
bordeaux.volume53en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - UMR 1219en_US
bordeaux.issueSuppl_1en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.teamELEANOR_BPHen_US
bordeaux.teamPHARES_BPHen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.identifierhal-03696352
hal.version1
hal.exportfalse
dc.rights.ccPas de Licence CCen_US
bordeaux.COinSctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Stroke&rft.date=2022-02&rft.volume=53&rft.issue=Suppl_1&rft.eissn=0039-2499&rft.issn=0039-2499&rft.au=WAZIRY,%20Reem&DUFOUIL,%20Carole&HOFMAN,%20Albert&IKRAM,%20Kamran&STEPHANIE,%20Debette&rft.genre=article


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