Abstract DP13: Long-term temporal trends in post-stroke dementia, 2002-2022: A population-wide cohort study
Bibliographic record
Abstract
Background: People with stroke are at high risk of dementia. There have been reductions in stroke case fatality and disability but temporal trends in the incidence and absolute burden of post-stroke dementia have not been described. Methods: We did a population-wide analysis of over 15 million people in Ontario, Canada between 2002-2022. Using linked administrative databases, we identified all 90-day dementia-free survivors of first acute ischemic stroke or intracerebral hemorrhage (ICH). We evaluated dementia incidence from 90-days after stroke onwards using a validated definition which included hospitalization, physician claims, and dementia medications. We calculated 1-year and 5-year incidence of dementia as percentages and per 100 person-years for each fiscal year, age-/sex-standardized by the 2002 population and with follow-up until March 2022. We stratified incidence trends by sex, stroke type, and severity (90-day home time of <60 days indicating moderate-severe stroke). We described trends in absolute number of people with post-stroke dementia, stratified by sex, and used linear regression to evaluate significance. Results: We identified 175,980 people with acute stroke surviving dementia-free to 90 days. From 2002-2021, there was modestly decreasing 1- and 5-year dementia incidence, primarily occurring from 2011 onwards (Figure 1). 5-year dementia decreased by an absolute change of -2.4% (15.5% to 13.1%) and a relative change of -15%. However, there was an increase in the number of people surviving with stroke (Figure 1A-B), so the absolute number of people with post-stroke dementia remained stable or increased over time (Figure 2). Women had higher age-standardized dementia incidence than men, but no difference in trends (Figure 3A-B). There was decreasing dementia incidence for ischemic stroke but no significant change for ICH (Figure 3C-D). Those with 90-day home time <60 days had twice the incidence of dementia compared to those with > 60 days, with no change over time (Figure 3E-F). Conclusion: In this large, population-wide study from 2002-2022, a modest decrease in post-stroke dementia incidence was offset by increasing numbers of stroke survivors and resulted in a rising absolute burden of post-stroke dementia. Those with more severe stroke had 2-fold higher dementia rate which did not change over time despite improvements in stroke care. New strategies are needed to address the persistent and increasing burden of post-stroke dementia.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.005 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".