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Ethnicity and risk of diagnosed dementia after stroke: a cohort study using the Clinical Practice Research Datalink
  1. Suhail Ismail Shiekh1,
  2. Harriet Forbes1,
  3. Rohini Mathur1,
  4. Liam Smeeth1,
  5. Neil Pearce2,
  6. Charlotte Warren-Gash1
  1. 1Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Population Health, London, UK
  2. 2Department of Medical Statistics, London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Population Health, London, UK
  1. Correspondence to Suhail Ismail Shiekh, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Population Health, London WC1E 7HT, UK; suhail.shiekh{at}lshtm.ac.uk

Abstract

Introduction The UK has over 1.2 million stroke survivors. Stroke is a major risk factor for dementia, and along with other risk factors such as hypertension and diabetes, is more common among Black, Asian and other ethnic minorities (BAME). We aimed to explore whether diagnosed dementia differed by ethnicity among adult stroke survivors.

Methodology Using the UK Clinical Practice Research Datalink and linked hospital data, we conducted a cohort study among patients aged ≥40 years who had an incident stroke between 2005 and 2016. We fitted multivariable Cox proportional hazard models to estimate ethnic differences in the risk of poststroke dementia, adjusting for major clinical and social confounders.

Results Our cohort comprised 45 474 stroke survivors (mean age 72.6 years, 49% female), of whom 95.7% were White, 2.0% South Asian, 1.2% Black and 1.1% of Mixed/Other ethnicity. Of these, 4624 (10.2%) were diagnosed with poststroke dementia over a median follow-up of 3.26 years. Compared with the White ethnic group, those of Black ethnicity were 42% more likely to be diagnosed with dementia (adjusted HR 1.42, 95% CI 1.05 to 1.93). There was no association between any other ethnic group and poststroke dementia diagnosis.

Discussion There was good evidence that those of Black ethnicity had higher risk of diagnosed dementia poststroke. Further understanding of the mechanisms of this relationship could help target interventions at communities most at risk of dementia poststroke.

  • stroke
  • dementia
  • ethnicity
  • epidemiology

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Footnotes

  • Contributors HF and CW-G conceived the study. HF and SIS extracted and managed the data. SIS conducted data management, data analysis, and wrote the main manuscript. RM, LS, NP, HF and CW-G contributed advice and comments on interpretation of results and writing of the paper. All authors approved the final draft.

  • Funding This work was funded through a Wellcome Intermediate Clinical Fellowship held by Charlotte Warren-Gash (201440_Z_16_Z).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval We obtained ethical approval from the Independent Scientific Advisory Committee (ISAC) (protocol number 18_0009) and the London School of Hygiene and Tropical Medicine (approval number 15386).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data may be obtained from a third party and are not publicly available.

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