Stroke may increase risk of Alzheimer disease

December 15, 2003

CHICAGO - People who have had a stroke are at an increased risk for developing Alzheimer disease (AD), especially if they also have cardiovascular disease, according to an article in the December issue of The Archives of Neurology, one of the JAMA/Archives journals.

According to information in the article, Alzheimer disease and stroke are common in the elderly population, but the relationship between these two disorders remains uncertain.

Richard Mayeux, M.D., M.Sc., of Columbia University, New York, and colleagues investigated the association between stroke and AD in 1,766 Medicare patients (older than 65 years) without dementia or AD who participated in a follow-up study from 1992 through 1999. History of stroke and presence of cardiovascular disease were noted at the beginning of the study.

The researchers found that the annual incidence for AD was 5.2 percent among patients with stroke, and 4 percent for patients without stroke. Patients with stroke were roughly 60 percent more likely to develop AD than patients who had never had a stroke.

"The results demonstrate an association between a history of stroke and AD," the authors write. "Compared with persons with no history of stroke, there was an increased risk of AD in persons with a history of stroke. The risk was highest for those with stroke who also had established vascular risk factors, such as high blood pressure, type 2 diabetes mellitus, or heart disease. Moreover, a history of stroke was associated with an earlier age at onset of dementia," the researchers write.

"The observed association between stroke and AD might relate to an underlying systemic vascular disease process, or alternatively, to the additive effects of stroke and AD pathologic features, leading to an earlier age at onset of the disease," the authors conclude.
-end-
(Arch Neurol. 2003;60:1707-1712. Available post-embargo at archneurol.com)

Editor's Note: This study was supported by federal grants from the National Institutes of Health, Bethesda, Md., the Charles S. Robertson Memorial Gift for Alzheimer's Disease Research from the Banbury Fund, Huntington, N.Y., and the Blanchette Hooker Rockefeller Foundation, New York.

For more information, contact JAMA/Archives Media Relations at 312-464-JAMA (5262) or e-mail mediarelations@jama-archives.org.

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