Dementia May Impede Stroke Recovery

Lasting disability more common for those with previous mental decline, study finds

MONDAY, Oct. 31 (HealthDay News) -- People with dementia who suffer a stroke are more likely to be disabled and less likely to return home than stroke patients who didn't have dementia, a new study finds.

Researchers looked at 702 people who had dementia at the time they had a stroke and 8,602 patients without dementia who had a stroke.

The stroke patients with pre-existing dementia were more likely to have moderate to severe disability when discharged from the hospital (81 percent vs. 57 percent) and were less likely to return to the place they lived before their stroke (24 percent vs. 45 percent).

The researchers also found that patients with dementia were more likely to have a severe stroke and an abnormal heart rhythm and less likely to receive the drug tPA, a clot-busting medication used to treat stroke.

A stroke, sometimes referred to as a "brain attack," occurs when blood stops circulating to the brain. The study appears in the Nov. 1 issue of the journal Neurology.

"Our findings represent a growing challenge for the health care system as baby boomers age and their risk of stroke and dementia increases," lead study author Dr. Gustavo Saposnik, of the University of Toronto in Canada, said in a journal news release.

"How to best manage stroke patients with pre-existing dementia is under debate and raises several diagnostic, management and ethical issues as some facilities may limit access to specialized stroke care for dementia patients unless the care is likely to improve outcomes," he noted.

"The lack of established guidelines for the management and treatment of stroke patients with dementia contributes to this uncertainty," Saposnik added.

Another study is being conducted to determine whether dementia itself or other factors such as hypertension, diabetes, atrial fibrillation and smoking are responsible for the poorer prognosis that stroke patients with pre-existing dementia face.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about stroke and stroke prevention.

Robert Preidt SOURCE: Neurology, news release, Oct. 26, 2011

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