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Prestroke dementia in patients with atrial fibrillation

Frequency and associated factors

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Abstract

Background and purpose

Prestroke dementia is frequent but usually not identified. Non–valvular atrial fibrillation (NVAF) is independently associated with an increased risk for dementia. However, the frequency and determinants of prestroke dementia in patients with NVAF have never been evaluated.

Objective

The aim of this study was to determine the frequency of prestroke dementia and associated factors in patients with a previously known NVAF.

Methods

This is an ancillary study of Stroke in Atrial Fibrillation Ensemble II (SAFE II), an observational study conducted in patients with a previously known NVAF, consecutively admitted for an acute stroke in French and Italian centers. Prestroke dementia was evaluated by the IQCODE in patients with a reliable informant. Patients were considered as demented before stroke when their IQCODE score was ≥ 104.

Results

of 204 patients, 39 (19.1%; 95% confidence interval [CI]: 13.7%–24.5%) patients met criteria for prestroke dementia. The only variable independently associated with prestroke dementia was increasing age (adjusted odds ratio for 1 year increase in age: 1.10; 95 % CI: 1.04–1.17), and there was a nonsignificant tendency for previous ischemic stroke or TIA and arterial hypertension.

Conclusion

One fifth of stroke patients with a previously known NVAF were already demented before stroke. The main determinant of prestroke dementia is increasing age. A large cohort is necessary to identify other determinants.

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Author information

Authors and Affiliations

  1. Dept. of Neurology, Stroke Dept. and Memory Center, University of Lille Roger Salengro Hospital, 59037, Lille, France

    C. Lefebvre MD, D. Deplanque MD, PhD, H. Hénon MD, PhD, F. Pasquier MD, PhD & D. Leys MD, PhD

  2. Dept. of Pharmacology, University of Lille, Lille, France

    D. Deplanque MD, PhD

  3. Dept. of Neurology, Sainte–Anne Hospital, Paris, France

    E. Touzé MD

  4. Institute of Neuroscience, University of Perugia, Perugia, Italy

    L. Parnetti MD, PhD & V. Gallai† MD, PhD

Authors
  1. C. Lefebvre MD
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  2. D. Deplanque MD, PhD
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  3. E. Touzé MD
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  4. H. Hénon MD, PhD
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  5. L. Parnetti MD, PhD
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  6. F. Pasquier MD, PhD
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  7. V. Gallai† MD, PhD
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  8. D. Leys MD, PhD
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Consortia

on behalf of the SAFE II investigators*

Corresponding author

Correspondence to D. Leys MD, PhD.

Additional information

*Steering committee: D. Leys, chairman; D.Deplanque, study coordinator; R. Schmidt, national coordinator–Austria; J. De Reuck, national coordinator–Belgium; JL Mas, national coordinator–France;V. Gallai1 and L.Parnetti,national coordinators–Italy; Jose Ferro,national coordinator– Portugal.

List of centers participating in the dementia substudy: France: Amiens (S. Canaple, O. Godefroy), Bayonne (E. Ellie), Besançon (Th. Moulin), Bordeaux (I. Sibon), Bourg en Bresse (J. Bouillat), Clichy (C. Masson), Dijon (M. Giroud), Dreux (Ph. Rondepierre), Lille (D. Deplanque, C.Lefebvre,D.Leys),Nimes (P.Labauge),Orléans (I.Durieu), Paris Lariboisière (L. Benoit, Th. De Greslan; F.Woimant,), Paris Ste Anne (E. Touzé, JL Mas), Perpignan (D. Sablot), Rouen (A Triquenot; B. Mihout). Italy: Bari (M. Lastilla), Benevento (M. Feleppa), Catanzaro (E. De Caro), Genova (G. Regesta), Milano (G. Cislaghi, C.Novi), Napoli (A. Tessitore), Perugia (F. Corea, L. Parnetti,V. Gallai1), Pistoia (D. Sità, F.Volpi), Reggio Emilia (D. Guidetti, N.Marcello), Roma (M. Altieri, V. Di Piero, GL. Lenzi), Teramo (C. Bernardini), Venezia (S. D’Anna).

1deceased January 2004.

Funding: Research group on cognitive decline in degenerative and vascular disorders (EA 2691 from the Ministère de l’Education Nationale, de la Recherche et de la Technologie).

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Lefebvre, C., Deplanque, D., Touzé, E. et al. Prestroke dementia in patients with atrial fibrillation. J Neurol 252, 1504–1509 (2005). https://doi.org/10.1007/s00415-005-0900-2

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  • DOI: https://doi.org/10.1007/s00415-005-0900-2

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