Prestroke cognitive function and cerebrovascular disease: if they interact, it may not be through symptomatic stroke.

摘要

In this issue of Stroke, Reitz and coworkers explore the link between incident stroke and dementia in data from the Rotterdam Study.' The emphasis on incident stroke is important: previous studies to address this question have recruited patients at the time of stroke so that prestroke cognitive status has been inferred rather than measured directly.23 Therefore, this is the first truly prospective data to assess the relationship between prestroke cognitive decline, stroke and subsequent dementia. Incident stroke led to a doubling of dementia risk over a mean follow-up time of 3.9 years. An approximate doubling of risk has also been found in other cohorts like those from Rochester and Framingham, so this study provides important confirmation of this size of effect.