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Acute stroke care in dementia: A cohort study from the Swedish Dementia and Stroke Registries
Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Huddinge, Sweden.
Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping). Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.ORCID-id: ingemar.kareholt@ki.se
Department of Clinical Sciences Lund, Neurology, Lund University, Skåne University Hospital, Lund, Sweden.
Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Huddinge, Sweden.
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2018 (Engelska)Ingår i: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 66, nr 1, s. 185-194Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

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.

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.

Ort, förlag, år, upplaga, sidor
IOS Press, 2018. Vol. 66, nr 1, s. 185-194
Nyckelord [en]
Cohort studies, dementia, hospital management, ischemic stroke
Nationell ämneskategori
Neurologi Kardiologi
Identifikatorer
URN: urn:nbn:se:hj:diva-41987DOI: 10.3233/JAD-180653ISI: 000448213400009PubMedID: 30248059Scopus ID: 2-s2.0-85055146830OAI: oai:DiVA.org:hj-41987DiVA, id: diva2:1261674
Forskningsfinansiär
HjärnfondenVetenskapsrådet, 2012-2291; 2016-02317Sveriges Kommuner och Landsting, SKLForte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2017-01646DemensförbundetSvenska Sällskapet för Medicinsk Forskning (SSMF)Tillgänglig från: 2018-11-08 Skapad: 2018-11-08 Senast uppdaterad: 2019-01-07Bibliografiskt granskad

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