People with dementia less likely to return home after stroke: study
Toronto, November 3, 2011
Dr. Gustavo Saposnik
People with dementia are almost half as likely to return home after a stroke compared to those that did not have dementia prior to the stroke, new research shows.
Those with dementia were also more likely to suffer severe stroke, have an abnormal heart rhythm and less likely to receive tPA – a clot-busting drug used to treat stoke.
“Our findings represent a growing challenge for the health care system as baby boomers age and their risk of stroke and dementia increases,” said Dr. Gustavo Saposnik, lead author of the study and director of the Stroke Outcomes Research Unit at St. Michael’s Hospital.
The study was published today in Neurology, the medical journal of the American Academy of Neurology.
Researchers also found that people with dementia who had a stroke were three times more likely to have greater disability at discharge from the hospital – measured by how well they were able to carry out their usual activities –compared to people without dementia who had a stroke.
The study involved 9,304 people who had a stroke between 2003 and 2008. Of the participants, 702 had pre-existing dementia at the time of their stroke.
“The best way to manage stroke patients who have dementia is still under debate and raises several diagnostic, management and ethical issues,” said Dr. Saposnik, also a Heart and Stroke Foundation-funded researcher. “Some facilities may limit access to specialized stroke care for dementia patients unless the care is likely to improve outcomes.”
“There is a lack of established guidelines for the management and treatment of stroke patients with dementia,” he said.
Dr. Saposnik is leading another study that is underway to look at how pre-existing dementia and other contributing factors such as hypertension, diabetes, atrial fibrillation and smoking affect stroke outcomes.
About St. Michael’s Hospital
St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 23 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, and care of the homeless are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Center, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.