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Acute Stroke Care in Dementia: A Cohort Study from the Swedish Dementia and Stroke Registries
Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI). Jönköping University, Sweden.
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Number of Authors: 112018 (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]

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. 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.

Place, publisher, year, edition, pages
2018. Vol. 66, no 1, p. 185-194
Keywords [en]
Cohort studies, dementia, hospital management, ischemic stroke
National Category
Neurology Geriatrics
Identifiers
URN: urn:nbn:se:su:diva-162065DOI: 10.3233/JAD-180653ISI: 000448213400009PubMedID: 30248059OAI: oai:DiVA.org:su-162065DiVA, id: diva2:1266451
Available from: 2018-11-28 Created: 2018-11-28 Last updated: 2018-11-28Bibliographically approved

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  • apa
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