Highlights
- •Aphasia was associated with an increased risk of developing vascular dementia in patients with first-episode stroke but not dementia of non-vascular type.
- •The association between aphasia and risk of vascular dementia did not differ by age and sex.
- •The strength of the association between aphasia and vascular dementia was similar among patients with ischemic and hemorrhagic stroke.
Abstract
Background and purpose
Although findings from published studies suggest post-stroke aphasia is associated
with an increased risk of dementia, few studies have evaluated its association in
a nationally representative cohort with long-term follow-up. No studies have reported
data by type of stroke. Therefore, we examined the association between post-stroke
aphasia and the risk of developing dementia.
Methods
Using claims data from Taiwan's universal health insurance program, a cohort of patients
≥18 years old with an initial hospitalization for stroke in 2002–2005 were identified
and followed up until December 31, 2016. Patients with newly diagnosed aphasia during
stroke hospitalization or within 6 months of discharge were defined as the aphasia
group. Cox proportional hazards models were used to estimate hazard ratios (HRs) for
developing overall, vascular, and non-vascular dementia in patients with and without
post-stroke aphasia.
Results
During a median follow-up period of 7.9 and 8.6 years for the aphasia (n=17063) and
non-aphasia groups (n=105940), respectively, overall dementia incidence was similar,
whereas vascular dementia incidence was higher in the aphasia group (7.52 vs. 5.52
per 1000 person-years). The adjusted HRs (95% confidence intervals) were 1.11 (1.06–1.17),
1.42 (1.31–1.53), and 0.94 (0.88–1.01) for overall, vascular, and non-vascular dementia,
respectively. The association between aphasia and the risk of vascular dementia did
not differ by stroke type (P for interaction=0.43). The analysis of 16856 propensity score-matched pairs revealed
similar results.
Conclusion
Patients with post-stroke aphasia have an increased risk of developing vascular dementia
irrespective of the type of stroke.
Key Words
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Article Info
Publication History
Published online: October 22, 2022
Accepted:
October 16,
2022
Received in revised form:
September 25,
2022
Received:
April 13,
2022
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106838
Copyright
© 2022 Elsevier Inc. All rights reserved.
