The Effect of Different Diagnostic Criteria on the Prevalence and Incidence of Post-stroke Dementia

There is little agreement about the prevalence and incidence of vascular dementia (VaD) mainly because investigators have used different diagnostic criteria. The aim of this study was to examine the influence of different diagnostic criteria on the prevalence and cumulative incidence of VaD in first-ever stroke patients (n = 194) clinically evaluated at 1, 6, 12, and 24 months after stroke. Post-stroke VaD was diagnosed using the DSM-III, DSM-III-R, DSM-IV, ICD-10-NA, NINDS-AIREN, and ADDTC criteria. The prevalence of dementia was highest at 1 month; ranging from 11.3% with the NINDS-AIREN to 20.1% with the ICD-10-NA. The incidence was highest at 6 months, ranging from 2.6% with the ADDTC to 5.2% with the ICD-10-NA. Agreement among diagnostic criteria was high, with the exception of the ADDTC. In conclusion, both the prevalence and incidence of dementia are highest directly after stroke, but exact rates are influenced by the diagnostic criteria used.