FUTURE STROKE LINKED WITH EARLIER DEMENTIA IN ELDERLY.

Byline: Denise Mann Medical Tribune News Service

Senior citizens who show signs of confusion may be more likely to experience a stroke than those who have no cognitive problems, according to Italian researchers.

In a new study of 5,024 elderly people, those who fared poorly on a test of mental skills were 2-1/2 times more likely to have a stroke than those who did well on the test of basic knowledge, Dr. Luigi Ferrucci of the National Research Institute in Florence, Italy, reported in the March issue of the Journal of the American Geriatric Society.

Scientists still do not understand the link between the two conditions. But the same plaque buildup that slows the supply of oxygen-rich blood to the brain, increasing one's risk of stroke, also may affect the processes leading to dementia, Ferrucci speculated.

There are many types of dementia, most of them characterized by personality changes, confusion and sluggishness. Thinking and the ability to reason and remember are also impaired by this disorder. By some estimates, dementia, primarily Alzheimer's disease, affects about 11 percent of people over 65.

In the new study, 259 of the senior citizens suffered strokes during about four years of follow-up. The researchers then went back and looked at the seniors' scores on the Short Portable Mental Status Questionnaire when they entered the study.

Elderly people who had done poorly on the mental skills test had the highest risk of stroke, those who had moderate mental impairment had a moderate risk of stroke, and those who had normal mental function had the lowest stroke risk, according to Ferrucci.

About 79 percent of the senior citizens scored in the normal range, 18 percent showed signs of mild mental impairment, and 3 percent showed signs of severe mental deterioration.

The results are "very interesting, this is a good solid study," said Andrew Monjan, chief of the neurobiology of aging branch at the National Institute on Aging in Bethesda, Md.

But another researcher is not that certain the findings will be helpful to doctors. "Researchers may not be paying enough attention to the association between stroke and memory loss, but will these new findings change the face of dementia diagnosis and treatment?" asked Dr. Britt Anderson, a neurologist at the University of Alabama at Birmingham's Alzheimer's Disease Center. "I don't think so."

Anderson said that the memory loss could have been spurred by undiagnosed strokes in the senior citizens. If a stroke or bleeding in the brain goes undetected, cognitive function is likely to be impaired and such changes may erroneously be attributed to dementia, he said.

But while there is still no way to prevent Alzheimer's disease or other forms of dementia, people can reduce their risk of heart disease and stroke by quitting smoking, exercising, eating well and controlling high blood pressure, Monjan said.

"Reducing these risk factors may also reduce risks for mental impairment," he added. "The bottom line is: Lead a healthy life - it can't hurt you and it's likely to be good for you."