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Alzheimers Dement. 2018 Nov;14(11):1416-1426. doi: 10.1016/j.jalz.2018.06.3061. Epub 2018 Aug 31.

Stroke and dementia risk: A systematic review and meta-analysis.

Author information

1
University of Exeter Medical School, St Luke's Campus, Exeter, UK.
2
Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA; Department of Neurology and Stroke Program, University of Michigan, Ann Arbor, MI, USA.
3
NIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter Medical School, St Luke's Campus, Exeter, UK.
4
University of Exeter Medical School, St Luke's Campus, Exeter, UK. Electronic address: david.llewellyn@exeter.ac.uk.

Abstract

INTRODUCTION:

Stroke is an established risk factor for all-cause dementia, though meta-analyses are needed to quantify this risk.

METHODS:

We searched Medline, PsycINFO, and Embase for studies assessing prevalent or incident stroke versus a no-stroke comparison group and the risk of all-cause dementia. Random effects meta-analysis was used to pool adjusted estimates across studies, and meta-regression was used to investigate potential effect modifiers.

RESULTS:

We identified 36 studies of prevalent stroke (1.9 million participants) and 12 studies of incident stroke (1.3 million participants). For prevalent stroke, the pooled hazard ratio for all-cause dementia was 1.69 (95% confidence interval: 1.49-1.92; P < .00001; I2 = 87%). For incident stroke, the pooled risk ratio was 2.18 (95% confidence interval: 1.90-2.50; P < .00001; I2 = 88%). Study characteristics did not modify these associations, with the exception of sex which explained 50.2% of between-study heterogeneity for prevalent stroke.

DISCUSSION:

Stroke is a strong, independent, and potentially modifiable risk factor for all-cause dementia.

PMID:
30177276
PMCID:
PMC6231970
DOI:
10.1016/j.jalz.2018.06.3061
[Indexed for MEDLINE]
Free PMC Article

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