This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
Objective: Stroke increases the risk of dementias, including Alzheimer disease (AD), but it is unknown whether persons with AD have a higher risk of strokes. We investigated whether noninstitutionalized persons with AD were more likely to experience incident stroke than persons without AD and whether there are differences in the incidence of ischemic or hemorrhagic strokes.
Methods: We performed a register-based matched cohort study including all community-dwelling persons with verified clinical diagnosis of AD, residing in Finland on December 31, 2005, and a single age-, sex-, and region of residence–matched comparison person without AD for each individual with AD (n = 56,186, mean age 79.6 [SD 6.9] years). Persons with previous strokes and their matched participants were excluded, leaving 50,808 individuals with 2,947 incident strokes occurring between January 1, 2006, and December 31, 2009. Diagnosis of AD was based on prescription reimbursement register and diagnosis of stroke on hospital discharge register of Finland.
Results: AD dementia was not associated with risk of all strokes or ischemic strokes, but the risk of hemorrhagic strokes was higher among persons with AD (adjusted hazard ratio [95% confidence interval] 1.34 [1.12–1.61]). When the associations were analyzed according to age groups, AD was associated with higher risk of all strokes, regardless of etiology, in the 2 youngest age groups, but not in the older groups. Similar associations were observed when the results were categorized according to age at diagnosis.
Conclusions: Our findings suggest that persons with AD dementia, especially younger patients, have higher risk of hemorrhagic strokes.
GLOSSARY
- AD=
- Alzheimer disease;
- DSM-IV=
- Diagnostic and Statistical Manual of Mental Disorders, 4th edition;
- ICD=
- International Classification of Diseases;
- NINCS-ADRDA=
- National Institute of Neurological and Communicative Disorders and Stroke–Alzheimer’s Disease and Related Disorders Association
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at www.neurology.org
- Received June 20, 2012.
- Accepted September 13, 2012.
- © 2013 American Academy of Neurology
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
