Newly Diagnosed Dementia and Increased Risk of Hemorrhagic Stroke: A Nationwide Population-based Study

Background: This retrospective cohort study was designed to assess whether there is an association between newly diagnosed dementia and the risk of stroke. Methods: From Taiwan’s National Health Insurance Research Database of reimbursement claims, we identified 2811 patients with newly diagnosed dementia and 14,055 randomly selected, agematched patients without dementia. A Cox proportional hazards model was constructed to calculate the development of stroke, including ischemic stroke, and intracerebral, or subarachnoid hemorrhage. Results: During the 3-year follow-up period, 339 patients with dementia (12.06%) and 691 patients without dementia (4.92%) developed stroke. The adjusted HRs of developing stroke among newly diagnosed dementia patients were 2.33-times (range, 2.05–2.66), and the incidence of hemorrhagic stroke was higher than that of other stroke types. Patients who had Alzheimer’s disease were at the highest risk of hemorrhagic stroke. Conclusion: Individuals with dementia, especially Alzheimer’s disease, are at greater risk of developing stroke, especially in intracerebral and subarachnoid hemorrhage than patients without dementia. Early mental screening programs and health education should be initiated for dementia patients.