22. European Stroke Conference 433 Behavioral disorders and post-stroke dementia Body-Mass Index and cognition in post-stroke survivor K.H. Yu1, B.C. Lee2, M.S. Oh3, S. Jung4, J.H. Lee5, S.J. Cho6, H.Y. Kim7, D.E. Kim8, J.G. Cha9, S.H. Lee10, S.U. Kwon11, J.M. Park12, S.J. Lee13, H.J. Bae14, I.S Koh15 For Korean-Vascular Cognitive Impairment Harmonization Standards Study Group Hallym Univ. Sacred Heart Hospital, Anyang, SOUTH KOREA1, Hallym Univ. Sacred Heart Hospital, Anyang, SOUTH KOREA2, Hallym Univ. Sacred Heart Hospital, Anyang, SOUTH KO-REA3, Hallym Univ. Sacred Heart Hospital, Seoul, SOUTH KOREA4, Hallym Univ. Sacred Heart Hospital, Seoul, SOUTH KOREA5, Hallym Univ. Sacred Heart Hospital, Seoul, SOUTH KOREA6, Konkuk University Hospital, Seoul, SOUTH KOREA7, Dongguk University international Hospital, Seoul, SOUTH KOREA8, Dong-A University Hospital, Pusan, SOUTH KOREA9, Seoul National University Hospital, Seoul, SOUTH KOREA10, Asan Medical Center, Seoul, SOUTH KOREA11, Nowon Eulji Hospital, Seoul, SOUTH KOREA12, Daejeon Eulji Hospital, Dae-jeon, SOUTH KOREA13, Seoul National University Bundang Hospital, Bundang, SOUTH KO-REA14, National Medical center, Seoul, SOUTH KOREA15 Background Although many of obesity- and age-related hazardous effects on clinical outcomes have been recog-nized in cardiovascular disease, increasing evidence suppose that obesity also modulates the cogni-tive functions in Alzheimer’s disease dementia. However, it is not well known about the relationship between obesity and cognitive declines in stroke patients. We examined the association of obesity with the cognitive dysfunction in post-stroke survivors. Methods Data from the Korean Vascular Cognitive Impairment Harmonization Standards Study, which en-rolled 620 subjects with ischemic stroke within 7 days of symptom onset who were consecutively admitted to 12 university hospitals, were examined. Of the 620 patients, 506 were followed-up at 3 months after stroke. Of these, 353 were evaluated for cognitive functions using the mini-mental sta-tus examination (MMSE). Body mass index (BMI) was calculated as the metrics of obesity. Results. BMI was significantly associated with MMSE scores at 3 months after stroke onset (p=0.031, ANO-VA test). After adjusting with age, sex and educational levels for MMSE scores, these results were remained significantly (p=0.008, ANOVA test). In multiple comparison analysis by the quartiles of BMI values, stroke survivors with lowest and highest quartiles of BMI showed significantly lower cognitive functions (MMSE score; 23.1±6.6 for BMI 15.8~21.8, 24.6±4.8 for BMI 26.0~32.9) than those in patients with normal BMI values (MMSE score; 25.2±5.4 for BMI 21.9~23.8, 25.3±4.9 for BMI 23.9~25.9). Conclusion Our results demonstrate an inverse association between levels of BMI and cognitive status in stroke survivors. 516 © 2013 S. Karger AG, Basel Scientific Programme 434 Behavioral disorders and post-stroke dementia Low sensitivity but high specificity of dementia diagnosis on death certificates in patients with TIA and stroke: a prospective population-based cohort study S.T. Pendlebury1, S. Klaus2, I. Volonghi3, Z. Mehta4, P.M. Rothwell5 on behalf of the Oxford Vascular Study Stroke Prevention Research Unit, Nuffield Department of Clinical Neurosciences, Oxford, UNITED KINGDOM1, Stroke Prevention Research Unit, Nuffield Department of Clinical Neuro-sciences, Oxford, UNITED KINGDOM2, Stroke Prevention Research Unit, Nuffield Department of Clinical Neurosciences, Oxford, UNITED KINGDOM3, Stroke Prevention Research Unit, Nuffield Department of Clinical Neurosciences, Oxford, UNITED KINGDOM4, Stroke Prevention Research Unit, Nuffield Department of Clinical Neurosciences, Oxford, UNITED KINGDOM5 BACKGROUND: Death certificate data are often used to estimate disease burden and assess clin-ical outcome, but previous studies show that they underestimate rates of dementia. However, there have been few recent studies, virtually no data on specificity of death certificate diagnoses, and no studies of validity of reporting in patients with TIA and stroke. We studied the sensitivity and speci-ficity of death certificate reporting of dementia during follow-up of patients after TIA and stroke. METHODS: All patients with acute TIA and stroke were ascertained in a population-based study (Oxford Vascular Study; 2002-2007). Participants had functional and cognitive assessment at base-line and at 1, 6 and 12 months, 5 and 10 years, including mini-mental-state-examination (MMSE) and Montreal Cognitive assessment (MoCA). To identify dementia occurring between follow-up vis-its, or in patients missing visits, all primary care and hospital medical records were hand-searched. Dementia was defined as MMSE<24 and associated functional impairment not solely caused by stroke, and/or a clinical diagnosis of dementia. RESULTS: Of 1247 patients (age 75+13 years, 47% male, 32% TIA), 662 had died by April 2012, with death certificates available for 649 (98%). 282/649 (43.5%) had a diagnosis of dementia by study criteria in life, of whom only 33 (sensitivity = 13.5%) had dementia recorded on their death certificate. However, no patient had a false positive diagnosis of dementia on death certificate (spec-ificity = 100%). CONCLUSION: In keeping with previous studies in the general population, sensitivity of reporting of dementia on death certificates is very low after TIA and stroke, undermining utility for assessing incidence, prevalence and outcome in cohort studies. However, specificity of diagnosis was very high, suggesting that death certificate diagnosis would be appropriate for standard or nested case:- control studies.
Karger_ESC London_2013
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