RESUMEN
BACKGROUND: This report focused on investigating the relationship between alcohol consumption and dementia in elderly people through prospective studies. METHODS: We conducted a 2-year follow-up study of elderly people from six communities in Chongqing, China. Dementia was detected using the Mini-Mental State Examination (MMSE) and the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R). The relationship between alcohol consumption and dementia was investigated using multiple logistic regression models, adjusting for the potential confounders age, sex, educational level and cigarette smoking. RESULTS: Light-to-moderate drinking was associated with a significantly lower risk of dementia compared with non-drinking. Excessive drinking was related to a higher risk of dementia. The effect of light-to-moderate drinking seemed most prominent among vascular dementia, 0.63 (0.55-0.72) for Alzheimer's disease, 0.31 (0.19-0.51) for vascular dementia and 0.45 (0.12-1.69) for other dementia. In a model adjusting for confounding variables, a light-to-moderate intake of beer was associated with a significantly higher risk of dementia than a non-drinker of beer. For wine, a significantly lower risk of dementia existed for a light-to-moderate drinker. CONCLUSIONS: Light-to-moderate drinking was associated with a significantly lower risk of dementia compared with a non-drinker.
Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Demencia/epidemiología , Anciano , China/epidemiología , Demencia/clasificación , Demencia/diagnóstico , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Prevalencia , Factores de Riesgo , Índice de Severidad de la EnfermedadRESUMEN
BACKGROUND: Adhesion molecules play important roles in the pathophysiology of ischemic stroke. The aim of the present study was to investigate whether serum levels of soluble intercellular adhesion molecule 1 (sICAM-1), soluble vascular cellular adhesion molecule 1 (sVCAM-1) and soluble E-selectin were associated with neurological deterioration of ischemic stroke. METHODS: 238 consecutive patients with ischemic stroke examined within 24 h from onset were enrolled into the study. The stroke severity was daily assessed with the NIH Stroke Scale (NIHSS) within the first week after admission. Serum levels of sICAM-1, sVCAM-1 and sE-selectin after admission were measured using enzyme-linked immunosorbent assay. Multivariate logistic regression was used to analyze the association of serum levels of sICAM-1, sVCAM-1 and sE-selectin on admission with the neurological deterioration of ischemic stroke, adjusted for potential confounders. RESULTS: 52 (21.8%) out of 238 stroke patients suffered from neurological deterioration. Serum levels of sICAM-1 on admission of stroke patients were significantly higher than those of healthy controls. Compared with patients without deterioration, patients with neurological deterioration had higher levels of sICAM-1, but not of sVCAM-1 and sE-selectin. On multivariate logistic regression, the serum level of sICAM-1 on admission was associated with neurological deterioration of stroke (OR 2.92, 95% CI 1.41-6.05). Other variables associated with neurological deterioration were fasting serum glucose (OR 1.65, 95% CI 1.24-2.20), baseline fibrinogen (OR 1.31, 95% CI 1.13-1.52) and NIHSS score (OR 1.23, 95% CI 1.15-1.32). CONCLUSIONS: The serum level of sICAM-1 on admission is associated with neurological deterioration of ischemic stroke.
Asunto(s)
Isquemia Encefálica/sangre , Selectina E/sangre , Molécula 1 de Adhesión Intercelular/sangre , Accidente Cerebrovascular/sangre , Molécula 1 de Adhesión Celular Vascular/sangre , Anciano , Anciano de 80 o más Años , Isquemia Encefálica/complicaciones , Isquemia Encefálica/terapia , Estudios de Casos y Controles , China , Estudios de Cohortes , Femenino , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Accidente Cerebrovascular/etiología , Accidente Cerebrovascular/terapia , Resultado del TratamientoRESUMEN
BACKGROUND: Frequency of poststroke cognitive impairment is high in western countries, and the risk factors of poststroke cognitive impairment have not been fully understood yet. We sought to examine the frequency and risk factors of cognitive impairment after ischemic stroke in a large stroke cohort of China. METHODS: A total of 434 consecutive patients with ischemic stroke were enrolled. The cognitive status before and 3 months after stroke was evaluated using the Informant Questionnaire on Cognitive Decline in the Elderly and the Mini-Mental State Examination, respectively. Poststroke cognitive impairment was defined as cognitive impairment with concomitant stroke, stroke-related cognitive impairment was defined as cognitive impairment developing after index stroke, and cognitive impairment after first-ever stroke was defined as cognitive impairment developing after first-ever stroke. Logistic regression analysis was used to find the risk factors of cognitive impairment after stroke. RESULTS: (1) Frequency of poststroke cognitive impairment was 37.1%, that of stroke-related cognitive impairment was 32.2%, and that of cognitive impairment after first-ever stroke was 29.6%. (2) The patients with cognitive impairment more often had older age, low educational level, atrial fibrillation, prior stroke, everyday drinking, left carotid territory infarction, multiple lesions, embolism, and dysphasia. (3) The factors associated with poststroke cognitive impairment in logistic regression analysis were age (OR 1.215, 95% CI 1.163-1.268), low educational level (OR 2.023, 95% CI 1.171-3.494), prior stroke (OR 5.130, 95% CI 2.875-9.157), everyday drinking (OR 2.013, 95% CI 1.123-3.607), dysphasia (OR 3.994, 95% CI 1.749-9.120), and left carotid territory infarction (OR 2.685, 95% CI 1.595-4.521). CONCLUSIONS: Cognitive impairment is common 3 months after ischemic stroke in Chinese people. Risk factors for poststroke cognitive impairment include age, low educational level, everyday drinking, prior stroke, dysphasia, and left carotid territory infarction.
Asunto(s)
Isquemia Encefálica/complicaciones , Isquemia Encefálica/epidemiología , Trastornos del Conocimiento/epidemiología , Trastornos del Conocimiento/etiología , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/epidemiología , Anciano , Trastornos Cerebrovasculares/complicaciones , Trastornos Cerebrovasculares/epidemiología , China/epidemiología , Estudios de Cohortes , Femenino , Humanos , Modelos Logísticos , Masculino , Pruebas Neuropsicológicas , Factores de Riesgo , Población UrbanaRESUMEN
OBJECTIVE: We studied a large hospitalized cohort of patients aged 55 years and over with acute ischemic stroke to identify the frequency and predictors of poststroke dementia. METHODS: A total of 434 consecutive patients with ischemic stroke were enrolled in this study. During admission, the demographic data, vascular risk factors, stroke features, and neurological status information were collected. All subjects were examined by a battery of neuropsychological tests during admission and 3 months after stroke. Logistic regression analysis was used to find the predictors of poststroke dementia. RESULTS: (1) The frequency of poststroke dementia was 27.2%, that of stroke-related dementia was 21.6%, and that of dementia after first-ever stroke was 22.7% 3 months after stroke. (2) Univariate analysis indicated that older age, low educational level (Asunto(s)
Isquemia Encefálica/epidemiología
, Demencia Vascular/epidemiología
, Accidente Cerebrovascular/epidemiología
, Anciano
, Anciano de 80 o más Años
, Isquemia Encefálica/complicaciones
, Isquemia Encefálica/patología
, Distribución de Chi-Cuadrado
, China/epidemiología
, Estudios de Cohortes
, Intervalos de Confianza
, Demencia Vascular/etiología
, Demencia Vascular/patología
, Femenino
, Estudios de Seguimiento
, Humanos
, Modelos Logísticos
, Masculino
, Persona de Mediana Edad
, Oportunidad Relativa
, Valor Predictivo de las Pruebas
, Factores Socioeconómicos
, Accidente Cerebrovascular/complicaciones
, Accidente Cerebrovascular/patología