Abstract Details

Title Greater Baseline White Matter Disease Burden Does Not Predict Increased Risk of Dementia 90 Days after Ischemic Stroke

Topic Aging and Dementia

Presentation(s) P06 - (-)

Poster/Presentation
Number 031

Objective

Background BACKGROUND: Higher burden of PVWMD is frequently reported to have a strong correlation with incident cognitive decline. Our previous work demonstrated that greater PVWMD is a strong predictor of poor functional motor outcome 3 months after ischemic stroke.

Design/Methods DESIGN/METHODS: Within the GCNKSS population-based epidemiology study, we prospectively enrolled a cohort of 693 patients with acute ischemic stroke in 2010. PVWMD on baseline imaging was classified using the Fazekas scale. An outcomes interview was conducted 90 days post-stroke, which included the modified Rankin (mRS), Six-Item Screener (SIS), and 1-minute word list generation. Multivariable logistic regression was used to assess PVWMD in predicting abnormal post-stroke cognitive function.

Results RESULTS: Of the 590 who completed the follow-up interview, 42 were excluded due to pre-existing dementia. At 90 days, 126 subjects were impaired on the SIS and 410 on the word count. Those having abnormal SIS at 90 days post-stroke had significantly (p<0.01) older age, higher mRS prior to stroke, higher mRS at discharge and greater PVWMD. In the multivariable model, age, aphasia, and discharge mRS were significantly associated with abnormal SIS, but higher PVWMD was not. The multivariable model for word list generation produced similar findings. Unadjusted, PVWMD was highly associated with abnormal 90 day verbal fluency, but did not remain significant after adjusting for age, race, aphasia, and mRS at discharge.

Conclusions CONCLUSIONS: Our data suggest increased risk of dementia with advanced age and higher stroke severity. Unlike the case for motor outcomes, our data find poor correlation between 3-month cognitive impairment and baseline PVWMD. This supports the view that cognitive outcome needs to be considered independent of functional motor outcome in ischemic stroke survivors.

Authors/Disclosures
Brendan J. Kelley, MD, FAAN (University of Texas Southwestern) PRESENTER	Dr. Kelley has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Eli Lilly. Dr. Kelley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Labcorp. Dr. Kelley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Esai.
	No disclosure on file
Timothy Cunniff, PharmD	Dr. Cunniff has received personal compensation for serving as an employee of Paragon Biosciences. Dr. Cunniff has stock in Harmony Biosciences. Dr. Cunniff has stock in Emalex Biosciences.
Kathleen Alwell	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Daniel Woo, MD, FAAN (University at Buffalo)	The institution of Dr. Woo has received research support from NIH.
Matthew L. Flaherty, MD	Dr. Flaherty has received personal compensation for serving as an employee of Sense Diagnostics, Inc. Dr. Flaherty has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boeringher Engelheim. Dr. Flaherty has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for CSL Behring. Dr. Flaherty has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Alexion. Dr. Flaherty has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for various law firms. Dr. Flaherty has stock in Sense Diagnostics, Inc. The institution of Dr. Flaherty has received research support from NINDS. Dr. Flaherty has received intellectual property interests from a discovery or technology relating to health care.
Pooja Khatri, MD, FAAN (Univ of Cincinnati/Dept of Neuro)	The institution of Dr. Khatri has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lumosa. Dr. Khatri has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Bayer. The institution of Dr. Khatri has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Diamedica. Dr. Khatri has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Basking Biosciences. Dr. Khatri has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Heart Association. The institution of Dr. Khatri has received research support from Cerenovus. Dr. Khatri has received publishing royalties from a publication relating to health care.
Dawn O. Kleindorfer, MD, FAAN (University of Michigan Department of Neurology)	Dr. Kleindorfer has nothing to disclose.
Brett M. Kissela, MD, MS, FAAN (University of Cincinnati Hospital)	The institution of Dr. Kissela has received research support from NIH/NINDS. Dr. Kissela has a non-compensated relationship as a Board Member with AHA Regional Board that is relevant to AAN interests or activities.

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