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

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

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.

Publication types

  • Meta-Analysis
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Age Factors
  • Aged
  • Cognition*
  • Cognitive Dysfunction / epidemiology*
  • Cohort Studies
  • Dementia / epidemiology*
  • Diabetes Mellitus / epidemiology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Obesity / epidemiology
  • Prevalence
  • Risk Factors
  • Vascular Diseases / epidemiology*