Preprint Article Version 1 This version is not peer-reviewed

Anaemia and Incidence of Post Stroke Dementia

Version 1 : Received: 17 April 2019 / Approved: 19 April 2019 / Online: 19 April 2019 (09:41:13 CEST)

How to cite: Myint, P.K.; Macleod, M.J.; Clark, A.B.; Smith, T.O.; Bettencourt-Silva, J.H.; Metcalf, A.K.; Potter, J.F. Anaemia and Incidence of Post Stroke Dementia. Preprints 2019, 2019040212 (doi: 10.20944/preprints201904.0212.v1). Myint, P.K.; Macleod, M.J.; Clark, A.B.; Smith, T.O.; Bettencourt-Silva, J.H.; Metcalf, A.K.; Potter, J.F. Anaemia and Incidence of Post Stroke Dementia. Preprints 2019, 2019040212 (doi: 10.20944/preprints201904.0212.v1).

Abstract

Background: Whilst lack of concentration is a known symptom of anaemia, its association with post-stroke dementia is unclear. Methods: We used data from a UK regional stroke register. To be eligible, patient must have survived to discharge and had anaemia by WHO criteria.  Dementia status and other prevalent co-morbidities were assessed using ICD-10 codes. Patients were followed till May 2015 (mean follow-up 3.7 years, total person years = 27,769). Hazard Ratio for incident dementia was calculated using Cox-proportional hazards model controlling for potential confounders. Fine and Gray model was additionally constructed using mortality as the competing risk. Results: A total of 7,454 stroke patients were included with mean age (SD) of 75.9(12.3) years (50.2% men). Those with anaemia were older, has higher disability and co-morbidity burden prior to stroke. We observed a large amount of variation in the dementia incidence rates over time and that the hazard ratio increased every year.  The significant association between anaemia and dementia incidence was lost after controlling for pre-stroke Modified Rankin score (HR1.17(0.97,1.40)). With every 20g/dL increase in Hb was associated with a significant reduction in the risk of dementia after adjustment for age, sex, stroke factors and disability but lost significance after adjustment for vascular risk factors. Competing risk analyses showed similar results. Conclusion: Whilst we found no evidence of anaemia as a risk factor for post-stroke dementia, the findings may be limited by potential under recognition of post stroke dementia.

Subject Areas

stroke; post-stroke dementia; anaemia

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