Cognitive decline in a prospectively studied group of stroke survivors, with a particular emphasis on the >75's

Background: although cognitive decline is frequent after stroke, there has been very little work focussing upon older age groups, in whom the majority of strokes occur. Objective: to determine whether cognitive decline is more common in older (>75) compared to younger (<75) stroke survivors. Method: a cohort of 360 stroke survivors of all ages from a stroke register in Newcastle, UK, were assessed prospectively at 3 time points over 1 year with a standardized battery. Dementia was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria. Results: the overall one year prevalence of dementia was 23%, but rose from 7% in the under 65's to 53% in over 85's. People over 75 were significantly more likely to have dementia (Odds Ratio 8.9, 95% Confidence Intervals 4.1-19.1). Conclusion: the striking age related increase in the prevalence of dementia has important implications for service planning and clinical management.