A prospective study on factors influencing long-term survival after cerebral infarction

Objective To investigate effect of dementia on survival rate after ischemic stroke in China.Methods Neurological, neuropsychological and functional assessment was performed in 619 patients with ischemic stroke. Dementia was diagnosed on admission and 3 months after onset of stroke according to Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. All patients were planned to follow up for 2 years after stroke, the proportion of surviving patients with and without dementia and the relative risk of mortality were calculated.Results 146 patients (23.6%) were diagnosed as dementia 3 months after stroke, 39 of whom were pre-stroke dementia and 107 were stroke-related dementia. The cumulative proportion of surviving cases was 49. 3% in patients with post-stroke dementia after a median follow-up period of 19.4±8. 3 months, 53.7% in patients with stroke-related dementia after a median follow-up period of 21.3±9.1 months, and 92.0% in patients without dementia. Multivariate analysis found that the mortality was significantly related with dementia.The independent risk factors of fatality of dementia after cerebral infarction were age, Barthel index, atrial fibrillation and previous stroke. Conclusions Survival is reduced by dementia after stroke. Dementia is a predictor of mortality in patients after stroke.