Current view on post-stroke dementia

Psychogeriatrics. 2021 May;21(3):407-417. doi: 10.1111/psyg.12666. Epub 2021 Feb 19.

Abstract

Dementia is one of the leading complications after stroke affecting about one third of survivors. Prevalence of post-stroke dementia (PSD) differs between studies due to variability in methodology, characteristics of included patients, type of stroke, diagnostic tools used to identify patients with dementia, or time when the assessment was performed. Patients diagnosed with PSD are at higher risk of mortality, disability, and institutionalization. Aetiology of PSD may include mixed overlapping processes such as vascular brain pathology or Alzheimer's disease. Several risk factors have been found to increase PSD incidence, involving demographics, vascular factors, stroke characteristics, abnormalities on neuroimaging, and stroke complications. However, the influence of some other factors still remains unclear. PSD may coexist with other neuropsychiatric disorders and its association with post-stroke depression seems to be the most significant. There is a strong need for further research on possible genetic, biological, and inflammatory biomarkers. Also, there are no unambiguously efficacious methods of management. Continuing to address these issues will help to find more effective interventions directly targeting prevention and treatment of PSD in the future.

Keywords: cognitive decline; cognitive impairment; dementia; stroke.

Publication types

  • Review

MeSH terms

  • Dementia* / epidemiology
  • Dementia* / etiology
  • Humans
  • Neuroimaging
  • Risk Factors
  • Stroke* / complications
  • Stroke* / epidemiology
  • Survivors