Risk factors for incident dementia after stroke and transient ischemic attack

Abstract

BackgroundWe hypothesized that chronic brain changes are important substrates for incident dementia after stroke and transient ischemic attack (TIA). MethodsWe compared clinical and imaging features between patients with consecutive stroke/TIA with (n = 88) and without (n = 925) incident dementia at 3 to 6 months after a stroke/TIA. Pittsburg compound B (PiB) positron emission tomography was performed in 50 patients, including those with (n = 37) and without (n = 13) incident dementia. ResultsAge, history of diabetes mellitus, severity of white matter changes (WMCs), and medial temporal lobe atrophy (MTLA) were associated with incident dementia. Alzheimer's disease (AD)–like PiB retention was found in 29.7% and 7.7% (P = .032) of patients with and without incident dementia, respectively. ConclusionsChronic brain changes including WMCs, MTLA, and AD pathology are associated with incident dementia after stroke/TIA. Interventions targeting these chronic brain changes may reduce burden of vascular cognitive impairment.