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People with dementia less likely to
return home after stroke
November 2,
2011 -- New research shows people with
dementia who have a stroke are more likely
to become disabled and not return home
compared to people who didn't have dementia
at the time they had a stroke.
The study is published in the November 1,
2011, issue of Neurology®,
the medical journal of the American Academy
of Neurology.
"Our
findings represent a growing challenge for
the health care system as baby boomers age
and their risk of stroke and dementia
increases," said lead study author Gustavo
Saposnik, MD, MSc, of the University of
Toronto in Canada and member of the American
Academy of Neurology.
The study
involved 9,304 people who had a stroke
between 2003 and 2008. Of the group, 702
people had dementia at the time they had a
stroke.
Researchers
found the people with dementia who had a
stroke were three times more likely to have
greater disability at discharge from the
hospital compared to people without dementia
who had a stroke, with 81 percent of those
with dementia having moderate to severe
disability compared to 57 percent of those
without dementia. In addition, only 24
percent of the people in the dementia group
returned to the place they lived prior to
the stroke compared to 45 percent of people
without dementia.
People with
dementia were also more likely to have
severe stroke and an abnormal heart rhythm
and less likely to receive tPA, a
clot-busting drug used to treat stroke.
"How to best
manage stroke patients with pre-existing
dementia is under debate and raises several
diagnostic, management and ethical issues as
some facilities may limit access to
specialized stroke care for dementia
patients unless the care is likely to
improve outcomes," said Saposnik. "The lack
of established guidelines for the management
and treatment of stroke patients with
dementia contributes to this uncertainty."
Another study is underway to determine
whether dementia or other comorbid
conditions (e.g. hypertension, diabetes,
atrial fibrillation, smoking) are
responsible for the observed outcomes.
