Stroke is a major cause of morbidity in the industrialized world. It often results not only in physical disability, but also in significant cognitive impairment or dementia. Between 10 and 40% of patients with a recent stroke develop dementia.1-4 Although stroke was already recognized as an important cause of dementia more than one hundred years ago, research on determinants of poststroke dementia and the cognitive profile of dementia after a stroke has strongly intensified during the last decade. The diagnosis of dementia after a stroke is complex and poses clinicians for several problems. Poststroke dementia is a clinical entity with very heterogeneous cognitive disturbances, that may be characterized as cortical or subcortical, or a combination of the two. Furthermore, cognitive functioning may be hampered by the somatic symptoms that often accompany a stroke. In clinical practice, cognitive screening instruments take an important place, either to select patients who need further neuropsychological testing or as a diagnostic test in patients with obvious dementia. Most existing screening instruments that are used in a clinical setting, however, are developed to detect dementia compatible with Alzheimer’s disease and their value in detecting dementia after stroke is less well known. In this thesis, I describe and discuss the diagnosis of dementia after stroke, with emphasis on the value of screening instruments in the diagnosis of poststroke dementia. I will use the terms dementia after stroke and poststroke dementia for any type of dementia that occurs after a stroke, irrespective of its presumed cause.

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The Dutch Vascular Factors in Dementia Study was financially supported by a grant from the Netherlands Program for Research on Aging (NESTOR), funded by the Ministry of Education, Culture, and Science and the Ministry of Health, Welfare, and Sports. The external validation study of the Rotterdam-CAMCOG was financially supported by a grant from the Dutch Health Insurance Board (College voor Zorgverzekeringen). The support of the Stichting Neurovasculair Onderzoek Rotterdam is gratefully acknowledged. The contributions of the participating nursinghomes (Antonius Binnenweg, Antonius IJsselmonde, De Vijf Havens, De Rustenburg, and Rheuma Verpleeghuis) and Rehabilitation Center Rijndam in Rotterdam in both the Dutch Vascular Factors in Dementia Study and the external validation study of the R-CAMCOG are greatly acknowledged.
P.J. Koudstaal (Peter)
Erasmus University Rotterdam
hdl.handle.net/1765/39696
Erasmus MC: University Medical Center Rotterdam

de Koning, I. (2004, December 17). The value of screening instruments in the diagnosis of poststroke dementia . Retrieved from http://hdl.handle.net/1765/39696