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  • 1.
    Garcia-Ptacek, Sara
    et al.
    Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Farahmand, Bahman
    Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Religa, Dorota
    Department of Geriatric Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
    Cuadrado, Maria Luz
    Department of Medicine, Universidad Complutense, Madrid, Spain.
    Eriksdotter, Maria
    Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Mortality risk after dementia diagnosis by dementia type and underlying factors: a cohort of 15,209 patients based on the Swedish Dementia Registry2014In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 41, no 2, p. 467-477Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Knowledge on survival in dementia is crucial for patients and public health planning. Most studies comparing mortality risk included few different dementia diagnoses.

    OBJECTIVES:

    To compare mortality risk in the most frequent dementia disorders in a large cohort of patients with an incident diagnosis, adjusting for potential confounding factors.

    METHODS:

    15,209 patients with dementia from the national quality database, Swedish Dementia Registry (SveDem), diagnosed in memory clinics from 2008 to 2011, were included in this study. The impact of age, gender, dementia diagnosis, baseline Mini-Mental State Examination (MMSE), institutionalization, coresidency, and medication on survival after diagnosis were examined using adjusted hazard ratios (HR) with 95% confidence intervals (CI).

    RESULTS:

    During a mean follow-up of 2.5 years, 4,287 deaths occurred, with 114 (95% CI 111-117) deaths/1,000 person-years. Adjusted HR of death for men was 1.56 (95% CI 1.46-1.66) compared to women. Low MMSE, institutionalization, and higher number of medications were associated with higher HR of death. All dementia diagnoses demonstrated higher HR compared to Alzheimer's disease, with vascular dementia presenting the highest crude HR. After adjusting, frontotemporal dementia had the highest risk with a HR of 1.91 (95% CI 1.52-2.39), followed by Lewy body dementia (HR 1.64; 95% CI 1.39-1.95), vascular dementia (HR 1.55; 95% CI 1.42-1.69), Parkinson's disease dementia (HR 1.47; 95% CI 1.17-1.84), and mixed Alzheimer's disease and vascular dementia (HR 1.32; 95% CI 1.22-1.44).

    CONCLUSION:

    Worse cognition, male gender, higher number of medications, institutionalization, and age were associated with increased death risk after dementia diagnosis. Adjusted risk was lowest in Alzheimer's disease patients and highest in frontotemporal dementia subjects.

  • 2.
    Hoang, M. T.
    et al.
    Center for Alzheimer Research, Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Aging Research Center (ARC), Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    von Euler, M.
    Karolinska Institutet, Departments of Clinical Science and Education, Medicine, Södersjukhuset, Solna, Stockholm, Sweden.
    Jönsson, L.
    Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    von Koch, L.
    Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Eriksdotter, M.
    Center for Alzheimer Research, Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Garcia-Ptacek, S.
    Center for Alzheimer Research, Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Costs of Inpatient Rehabilitation for Ischemic Stroke in Patients with Dementia: A Cohort Swedish Register-Based Study2020In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 73, no 3, p. 967-979Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Stroke and dementia are frequent comorbidities. Dementia possibly increases total costs of stroke care, especially cost of institutionalization and informal medical care. However, stroke rehabilitation costs in dementia patients are understudied.

    OBJECTIVE:

    To estimate inpatient stroke rehabilitation costs for Swedish dementia patients in comparison with non-dementia patients.

    METHODS:

    A longitudinal cohort study with linked data from the Swedish Dementia Register and the Swedish Stroke Register was conducted. Patients diagnosed with dementia who suffered a first ischemic stroke between 2010 and 2014 (n = 138) were compared with non-dementia patients (n = 935). Cost analyses were conducted from a Swedish health care perspective. The difference of rehabilitation costs between the two groups was examined via simple linear regression (before and after matching by propensity scores of dementia) and multiple linear regression.

    RESULTS:

    Mean inpatient rehabilitation costs for dementia and non-dementia patients were SEK 103,693/$11,932 and SEK 130,057/$14,966, respectively (median SEK 92,183/$10,607 and SEK 106,365/$12,239) (p = 0.001). Dementia patients suffered from more comorbidities and experienced lower functioning, compared to non-dementia patients. The inpatient rehabilitation cost for patients with known dementia was 0.84 times the cost in non-dementia individuals.

    CONCLUSION:

    Dementia diagnosis was significantly associated with lower inpatient stroke rehabilitation costs. This might be explained by physicians' beliefs on the limited effectiveness of rehabilitation in dementia patients. Further research on cost-effectiveness of stroke rehabilitation and patients' satisfaction with stroke rehabilitation is necessary.

  • 3.
    Rizzuto, Debora
    et al.
    Department of Neurobiology, Care Sciences and Society, Aging Research Center (ARC), Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Feldman, Adina L.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Karlsson, Ida K.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Dahl Aslan, Anna K.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Gatz, Margaret
    Department of Psychology, University of Southern California, Los Angeles, California.
    Pedersen, Nancy L.
    Department of Psychology, University of Southern California, Los Angeles, California.
    Detection of dementia cases in two Swedish health registers: A validation study2018In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 61, no 4, p. 1301-1310Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Population-based health registers are potential assets in epidemiological research; however, the quality of case ascertainment is crucial.

    OBJECTIVE: To compare the case ascertainment of dementia, from the National Patient Register (NPR) and the Cause of Death Register (CDR) with dementia diagnoses from six Swedish population based studies.

    METHODS: Sensitivity, specificity, and positive predictive value (PPV) of dementia identification in NPR and CDR were estimated by individual record linkage with six Swedish population based studies (n = 19,035). Time to detection in NPR was estimated using data on dementia incidence from longitudinal studies with more than two decades of follow-up.

    RESULTS: Barely half of the dementia cases were ever detected by NPR or CDR. Using data from longitudinal studies we estimated that a record with a dementia diagnosis appears in the NPR on average 5.5 years after first diagnosis. Although the ability of the registers to detect dementia cases was moderate, the ability to detect non-dementia cases was almost perfect (99%). When registers indicate that there is a dementia diagnosis, there are very few instances in which the clinicians determined the person was not demented. Indeed, PPVs were close to 90%. However, misclassification between dementia subtype diagnoses is quite common, especially in NPR.

    CONCLUSIONS: Although the overall sensitivity is low, the specificity and the positive predictive value are very high. This suggests that hospital and death registers can be used to identify dementia cases in the community, but at the cost of missing a large proportion of the cases.

  • 4.
    Sindi, S.
    et al.
    Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Ngandu, T.
    Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden.
    Hovatta, I.
    Department of Biosciences, University of Helsinki, Helsinki, Finland.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Antikainen, R.
    Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.
    Hänninen, T.
    Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland.
    Levälahti, E.
    Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland.
    Laatikainend, T.
    Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland.
    Lindström, J.
    Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland.
    Paajanen, T.
    Institute of Occupational Health, Helsinki, Finland.
    Peltonen, M.
    Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland.
    Khalsa, D. S.
    Department of General Internal Medicine, Geriatrics and Integrative Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
    Wolozin, B.
    Departments of Pharmacology and Neurology, Boston University School of Medicine, Boston, MA, USA.
    Strandberg, T.
    Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.
    Tuomilehto, J.
    Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland.
    Soininen, H.
    Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland.
    Kivipelto, M.
    Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden.
    Solomon, A.
    Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden.
    Baseline telomere length and effects of a multidomain lifestyle intervention on cognition: The FINGER randomized controlled trial2017In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 59, no 4, p. 1459-1470Article in journal (Refereed)
    Abstract [en]

    Leukocyte telomere length (LTL) is a biomarker of aging, and it is associated with lifestyle. It is currently unknown whether LTL is associated with the response to lifestyle interventions. The goal is to assess whether baseline LTL modified the cognitive benefits of a 2-year multidomain lifestyle intervention (exploratory analyses). The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) was a 2-year randomized controlled trial including 1,260 people at risk of cognitive decline, aged 60-77 years identified from the general population. Participants were randomly assigned to the lifestyle intervention (diet, exercise, cognitive training, and vascular risk management) and control (general health advice) groups. Primary outcome was change in cognition (comprehensive neuropsychological test battery). Secondary outcomes were changes in cognitive domains: Memory, executive functioning, and processing speed. 775 participants (392 control, 383 intervention) had baseline LTL (peripheral blood DNA). Mixed effects regression models with maximum likelihood estimation were used to analyze change in cognition as a function of randomization group, time, baseline LTL, and their interaction. Intervention and control groups did not significantly differ at baseline. Shorter LTL was related to less healthy baseline lifestyle. Intervention benefits on executive functioning were more pronounced among those with shorter baseline LTL (p-value for interaction was 0.010 adjusted for age and sex, and 0.007 additionally adjusted for baseline lifestyle factors). The FINGER intervention cognitive benefits were more pronounced with shorter baseline LTL, particularly for executive functioning, indicating that the multidomain lifestyle intervention was especially beneficial among higher-risk individuals.

  • 5.
    Subic, Ana
    et al.
    Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.
    Cermakova, Pavla
    National Institute of Mental Health, Klecany, Czech Republic.
    Religa, Dorota
    Polish Academy of Sciences, Mossakowski Medical Research Center, Warsaw, Poland.
    Han, Shuang
    Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
    von Euler, Mia
    Department of Medicine-Solna, Karolinska Institutet, Stockholm, Sweden.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Johnell, Kristina
    Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Fastbom, Johan
    Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Bognandi, Liselia
    Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden.
    Winblad, Bengt
    Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden.
    Kramberger, Milica G
    Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.
    Eriksdotter, Maria
    Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden.
    Garcia-Ptacek, Sara
    Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden.
    Treatment of Atrial Fibrillation in Patients with Dementia: A Cohort Study from the Swedish Dementia Registry2018In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 61, no 3, p. 1119-1128Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Patients with dementia might have higher risk for hemorrhagic complications with anticoagulant therapy prescribed for atrial fibrillation (AF).

    OBJECTIVE: This study assesses the risks and benefits of warfarin, antiplatelets, and no treatment in patients with dementia and AF.

    METHODS: Of 49,792 patients registered in the Swedish Dementia Registry 2007-2014, 8,096 (16%) had a previous diagnosis of AF. Cox proportional hazards models were used to calculate the risk for ischemic stroke (IS), nontraumatic intracranial hemorrhage, any-cause hemorrhage, and death.

    RESULTS: Out of the 8,096 dementia patients with AF, 2,143 (26%) received warfarin treatment, 2,975 (37%) antiplatelet treatment, and 2,978 (37%) had no antithrombotic treatment at the time of dementia diagnosis. Patients on warfarin had fewer IS than those without treatment (5.2% versus 8.7%; p < 0.001) with no differences compared to antiplatelets. In adjusted analyses, warfarin was associated with a lower risk for IS (HR 0.76, CI 0.59-0.98), while antiplatelets were associated with increased risk (HR 1.25, CI 1.01-1.54) compared to no treatment. For any-cause hemorrhage, there was a higher risk with warfarin (HR 1.28, CI 1.03-1.59) compared to antiplatelets. Warfarin and antiplatelets were associated with a lower risk for death compared to no treatment.

    CONCLUSIONS: Warfarin treatment in Swedish patients with dementia is associated with lower risk of IS and mortality, and a small increase in any-cause hemorrhage. This study supports the use of warfarin in appropriate cases in patients with dementia. The low percentage of patients on warfarin treatment indicates that further gains in stroke prevention are possible.

  • 6.
    Tolppanen, Anna-Maija
    et al.
    University of Eastern Finland.
    Ngandu, Tiia
    Karolinska Institutet.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health. Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Laatikainen, Tiina
    University of Eastern Finland.
    Rusanen, Minna
    University of Eastern Finland.
    Soininen, Hilkka
    University of Eastern Finland.
    Kivipelto, Miia
    University of Eastern Finland.
    Midlife and Late-Life Body Mass Index and Late-Life Dementia: Results from a Prospective Population-Based Cohort2014In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 38, no 1, p. 201-209Article in journal (Refereed)
    Abstract [en]

    Background: Obesity has been consistently associated with dementia. The role of certain risk factors of dementia may change during life, and the importance of having a life-course perspective has been acknowledged. Objective: The aim of this study was to investigate the association of midlife and late-life body mass index (BMI) with late-life dementia/Alzheimer's disease (AD) and whether the association was independent of other obesity-related co-morbidities. Methods: The association between midlife BMI (mean age 50.2, SD 6.0) and late-life BMI (mean age 71.2, SD 4.0) and incident dementia later in life (mean age 75.7, SD 5.0) were investigated among 1,304 participants of the longitudinal population-based Cardiovascular risk factors, Aging and Dementia (CAIDE) study, conducted in Eastern Finland. The duration of follow-up was 26 years. The diagnosis of dementia was based on DSM-IV criteria and the probable and possible AD on the NINCDS-ADRDA criteria. Results: Higher midlife BMI was associated with higher risk of incident dementia (adjusted HR, 95% CI 1.07, 1.00–1.14). However, decrease in BMI from midlife to late-life was associated with higher risk of dementia (1.14, 1.03–1.25 for one-unit decrease) and AD (1.20, 1.09–1.33). High late-life BMI was associated with lower risk of AD (0.89, 0.81–0.98) but the association with dementia was less evident (0.94, 0.86–1.03). Conclusion: Higher midlife BMI is related to higher risk of dementia and AD, independently of obesity-related risk factors and co-morbidities. Steeper decrease of BMI and low late-life BMI are associated with higher risk of dementia and AD. These findings highlight the importance of life-course perspective when assessing the association between BMI and cognition.

  • 7. Wallin, Karin
    et al.
    Solomon, Alina
    Kåreholt, Ingemar
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology.
    Tuomilehto, Jaakko
    Soininen, Hilkka
    Kivipelto, Miia
    Midlife rheumatoid arthritis increases the risk of cognitive impairment two decades later: a population-based study2012In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 31, no 3, p. 669-676Article in journal (Refereed)
    Abstract [en]

    Inflammation has been associated with Alzheimer's disease (AD) and dementia. The association between rheumatoid arthritis (RA) or arthritis and dementia/AD has been investigated in several case-control or hospital- and register-based studies with mixed results. This long-term population-based study investigates the association between presence of joint disorders (RA and other joint disorders) in midlife and cognitive status later in life. 1,449 participants were first evaluated in 1972, 1977, 1982, and 1987 and follow-up was performed after 21 years. A self-administered questionnaire including questions on joint disorders was used at both evaluations. Cognitive status (control, mild cognitive impairment, dementia/AD) was assessed at follow-up. The presence of any joint disorder in midlife was significantly associated with a worse cognitive status later in life: OR (95% CI) in an ordinal logistic regression analysis adjusted for age, gender, follow-up time, education, APOEε4, body mass index, smoking, drug treatment, and diabetes was 1.96 (1.17-3.28). For RA only, OR (95% CI) was 2.77 (1.26-6.10). The correlation remained significant for RA when AD was considered instead of dementia OR (95% CI) 2.49 (1.09-5.67). The presence of joint disorders, especially RA, at midlife seems to be associated with a worse cognitive status later in life. Given the chronic inflammatory component of RA, this study suggests that inflammatory mechanisms may have an important role in increasing the risk of cognitive impairment and dementia/AD.

  • 8.
    Zupanic, Eva
    et al.
    Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Huddinge, Sweden.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, 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.
    Norrving, Bo
    Department of Clinical Sciences Lund, Neurology, Lund University, Skåne University Hospital, Lund, Sweden.
    Secnik, Juraj
    Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Huddinge, Sweden.
    von Euler, Mia
    Department of Clinical Science and Education, Södersjukhuset and Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
    Winblad, Bengt
    Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Huddinge, Sweden.
    Religa, Dorota
    Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Huddinge, Sweden.
    Kramberger, Milica Gregoric
    Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Huddinge, Sweden.
    Johnell, Kristina
    Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Eriksdotter, Maria
    Karolinska University Hospital, Stockholm, Sweden.
    Garcia-Ptacek, Sara
    Karolinska University Hospital, Stockholm, Sweden.
    Acute stroke care in dementia: A cohort study from the Swedish Dementia and Stroke Registries2018In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 66, no 1, p. 185-194Article in journal (Refereed)
    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.

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