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Acute stroke care in dementia: A cohort study from the Swedish Dementia and Stroke Registries
Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Huddinge, Sweden.
Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.ORCID iD: ingemar.kareholt@ki.se
Department of Clinical Sciences Lund, Neurology, Lund University, Skåne University Hospital, Lund, Sweden.
Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Huddinge, Sweden.
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2018 (English)In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 66, no 1, p. 185-194Article in journal (Refereed) Published
Abstract [en]

METHODS: Retrospective analysis of prospectively collected data 2010-2014 from the Swedish national dementia registry (SveDem) and the Swedish national stroke registry (Riksstroke). Patients with dementia who suffered an acute ischemic stroke (AIS) (n = 1,356) were compared with matched non-dementia AIS patients (n = 6,755). Outcomes included length of stay in a stroke unit, total length of hospitalization, and utilization of diagnostic tests and assessments.

RESULTS: The median age at stroke onset was 83 years. While patients with dementia were equally likely to be directly admitted to a stroke unit as their non-dementia counterparts, their stroke unit and total hospitalization length were shorter (10.5 versus 11.2 days and 11.6 versus 13.5, respectively, p < 0.001). Dementia patients were less likely to receive carotid ultrasound (OR 0.36, 95% CI [0.30-0.42]) or undergo assessments by the interdisciplinary team members (physiotherapists, speech therapists, occupational therapists; p < 0.05 for all adjusted models). However, a similar proportion of patients received CT imaging (97.4% versus 98.6%, p = 0.001) and a swallowing assessment (90.7% versus 91.8%, p = 0.218).

CONCLUSIONS: Patients with dementia who suffer an ischemic stroke have equal access to direct stroke unit care compared to non-dementia patients; however, on average, their stay in a stroke unit and total hospitalization are shorter. Dementia patients are also less likely to receive specific diagnostic tests and assessments by the interdisciplinary stroke team.

BACKGROUND: Previous studies have shown that patients with dementia receive less testing and treatment for stroke.

OBJECTIVES: Our aim was to investigate hospital management of acute ischemic stroke in patients with and without dementia.

Place, publisher, year, edition, pages
IOS Press, 2018. Vol. 66, no 1, p. 185-194
Keywords [en]
Cohort studies, dementia, hospital management, ischemic stroke
National Category
Neurology Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:hj:diva-41987DOI: 10.3233/JAD-180653ISI: 000448213400009PubMedID: 30248059Scopus ID: 2-s2.0-85055146830OAI: oai:DiVA.org:hj-41987DiVA, id: diva2:1261674
Funder
The Swedish Brain FoundationSwedish Research Council, 2012-2291; 2016-02317Swedish Association of Local Authorities and RegionsForte, Swedish Research Council for Health, Working Life and Welfare, 2017-01646The Dementia Association - The National Association for the Rights of the DementedSwedish Society for Medical Research (SSMF)Available from: 2018-11-08 Created: 2018-11-08 Last updated: 2019-01-07Bibliographically approved

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