Study on risk factors of incidence and mortality of dementia after stroke
Objective To investigate the risk of dementia following a stroke and explore the factors influencing the occurrence,providing a scientific basis for reducing the risk of post-stroke dementia.Methods A follow-up cohort was constructed based on the UK Biobank database,and multi-state models were used to predict the risk of stroke and dementia transitions and analyze influencing factors.Results Among six transition paths,the cumulative risk of transitioning from dementia to death was the highest,followed by stroke to death and stroke to dementia.The risk of developing dementia after stroke was 4.1 times higher than that at baseline.Factors influencing the three transition states(stroke,dementia,and death)in the baseline population included age(over 45 years),male gender,current or previous history of smoking,occasional or frequent napping,low physical activity,central obesity,and current alcohol consumption.Current alcohol use reduced the risk of stroke,dementia,and death in the baseline population.Elder(over 65 years old)[hazard ratio(HR)=14.15,95％confidence interval(CI):1.97-101.39],occasional napping(HR=1.55,95％CI:1.19-2.02)and central obesity(HR=1.43,95％CI:1.05-1.95)were the risk factors in the development of dementia in stroke patients.High physical activity was a protective factor against dementia in stroke patients(HR=0.72,95％CI:0.52-0.99).Older age(over 55 years),male gender(HR=1.40,95％CI:1.26-1.56),current smoking(HR=1.25,95％CI:1.06-1.47),and sometimes napping(HR=1.14,95％CI:1.03-1.27)were identified as risk factors for mortality in patients with dementia.Conclusions Older age(over 65 years),occasional napping,and central obesity can increase the risk of dementia in stroke individuals,while high physical activity decreases the risk of dementia occurrence.The multi-state model can be used to show the influencing factors and degree of disease metastasis and reveal the changing law of disease process.
万方数据
维普
