Page 268 - merged

S058-4

Risk Factors and Etiology of Delayed-onset Dementia after Stroke/Transient
Ischemic Attack: STroke Registry Investigating Cognitive DEcline (STRIDE)
Study

Bonnie Yin Ka Lam

Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin,
Hong Kong SAR, China

Background/Objective: We hypothesised that concurrent cerebral small vessel disease (SVD)
and/or Alzheimer’s disease (AD) pathologies predicted delayed-onset dementia after stroke/transient
ischemic attack (TIA).

Method: Dementia-free subjects (n=919) who were recruited into the STRIDE study were
followed-up for a 3-year period. We investigated the relationship between baseline clinical,
neuropsychological, genetic, and imaging measures with delayed-onset dementia using logistic
regression. Pittsburg compound B (PiB) positron emission tomography was performed on 31 patients
with (n=10) and without delayed-onset dementia (n=21).

Result: Forty subjects (4.4%) developed dementia during the study period. Presence of ≥ 3 lacunes
(OR=2.6, 95% CI=1.3 to 5.3) and severe white matter changes (OR=2.6, 95% CI=1.3 to 5.1)
significantly predicted delayed-onset dementia after adjusted to age, education and gender. Medial
temporal lobe atrophy and apolipoprotein e4 status were not associated with dementia. There was no
significant difference in proportion of subjects having AD-like PiB retention among those with
(n=3/10, 30%) and without dementia (n=3/21, 14%, p=0.30).

Conclusion: Severe SVD, rather than AD, was associated with delayed-onset dementia after
stroke/TIA.