Stroke and dementia risk: A systematic review and meta-analysis |
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| Authors: | Elżbieta Kuźma Ilianna Lourida Sarah F Moore Deborah A Levine Obioha C Ukoumunne David J Llewellyn |
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| Institution: | 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;3. Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA;4. Department of Neurology and Stroke Program, University of Michigan, Ann Arbor, MI, USA;5. NIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter Medical School, St Luke''s Campus, Exeter, UK |
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| Abstract: | IntroductionStroke is an established risk factor for all-cause dementia, though meta-analyses are needed to quantify this risk.MethodsWe 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.ResultsWe 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.DiscussionStroke is a strong, independent, and potentially modifiable risk factor for all-cause dementia. |
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| Keywords: | Corresponding author Tel : 0044(0)1392 72 6018 Fax: 0044(0)1392722894 |
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