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Department of Neurology, Columbia University, College of Physicians and Surgeons, New York, NY.(Drs. Tatemichi, Desmond, Mayeux, Stern, Sano, Williams, Mohr, Hauser, and Figueroa)
Department of Psychiatry, Columbia University, College of Physicians and Surgeons, New York, NY. (Drs. Mayeux, Stern, Remien, and Williams)
Division of Biostatistics, Columbia University, College of Physicians and Surgeons, New York, NY.(Dr. Paik)
Gertrude H. Sergievsky Center, Columbia University, College of Physicians and Surgeons, New York, NY. (Drs. Mayeux, Hauser, and Stern)
We determined the frequency of dementia in a cohort of 251 patients aged 
60 years hospitalized with acute ischemie stroke, based on examinations performed 3 months after stroke onset. Using modified DSM-III-R criteria, we found dementia in 66 patients (26.3%). Diagnostic agreement among raters was excellent (kappa = 0.96). In a control sample of 249 stroke-free subjects recruited from the community and matched by age, we found dementia in eight subjects (3.2%). Using a logistic regression model to estimate the risk of dementia associated with stroke in the combined samples, the odds ratio (OR) for stroke patients compared with control subjects was 9.4 (p <0.001). Advancing age and fewer years of education were significant, independent correlates of dementia, with a trend evident for race (non-white versus white). Confining the analysis to subjects residing in the Washington Heights-Inwood community of northern Manhattan, the OR was 10.3 (p <0.001) with significant age and race effects. We conclude that ischemie stroke significantly increases the risk of dementia, with independent contributions by age, education, and race.
Address correspondence and reprint requests to Dr. T.K. Tatemichi, Stroke and Aging Research Project, Neurological Institute, 710 West 168th Street, New York, NY 10032.
Supported in part by Grants R01-NS26179 and P01-AG07232 from the National Institutes of Health.
Presented in part at the 43rd annual meeting of the American Academy of Neurology, Boston, MA, April 1991.
Received September 23, 1991. Accepted for publication in final form November 12, 1991.
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