Time Trends and Characteristics of Prevalent Dementia among Patients Hospitalized for Stroke in the United States.

BACKGROUND: Little is known about how prevalent dementia rates among patients with stroke have evolved over the last decade or how this relationship varies by gender, race ethnicity, stroke type, or dementia type. We assessed time trends and demographic predictors of coexisting dementia in a large cohort of patients hospitalized for stroke.

MATERIALS AND METHODS: Patient admission data between 1999 and 2012 were sourced from the National Inpatient Sample. Patient admission records were included in the retrospective analysis if they were diagnosed with ischemic or hemorrhagic stroke during admission. Predictors of dementia subtype were analyzed using unadjusted and adjusted multinomial logistic regression.

RESULTS: Of 1,170,051 patients hospitalized for stroke between 1999 and 2012, 66,703 (5.7%) had a coexisting diagnosis of dementia. Female gender was associated with increased odds of Alzheimer's dementia (AD) (adjusted odds ratio [aOR] 1.15, 95% confidence interval [CI] 1.11-1.19) but decreased odds of both vascular dementia (VaD) (aOR .50, 95% CI .44-.58) and non-Alzheimer's-nonvascular dementia (aOR .79, 95% CI .79, 95% CI .74-.83). Relative to whites, African-Americans had higher odds of AD (aOR 1.25, 95% CI 1.18-1.32) and VaD (aOR 1.51, 95% CI 1.40-1.64). Similarly, Hispanics had increased odds of AD (aOR 1.40, 95% CI 1.30-1.50).

CONCLUSIONS: Rates of coexisting dementia among patients hospitalized for stroke in the United States have risen over the last decade. Prevalence of dementia among these patients varies by gender and race-ethnicity. Key demographic groups may need to be targeted to reduce disparities in dementia occurrence.