Stroke, Cardiovascular Disease, and Dementia After Hospitalized TIA

作者：Kamakshi Lakshminarayan, Faye L. Norby, Ching-Ping Hong, A.R. Folsom, Wayne D. Rosamond, Rebecca F. Gottesman, Silvia Koton, James Russell Pike, Pamela L. Lutsey · 发表于：Neurology · 年份：2025 · DOI：10.1212/wnl.0000000000214020 · 被引用次数：3 · 研究领域：Dementia and Cognitive Impairment Research、Acute Ischemic Stroke Management、Frailty in Older Adults

BACKGROUND AND OBJECTIVES: There are inconsistent data on the long-term risk of dementia after TIA. We used the multidecade Atherosclerosis Risk in Communities (ARIC) study to examine long-term risk of incident dementia and other post-TIA outcomes. METHODS: The ARIC study recruited participants from 4 US communities-Minneapolis, MN; Jackson, MS; Forsyth County, NC; and Washington County, MD-during the years 1987-1989. Participants have been followed through in-person visits, phone calls, and hospital and death registry surveillance. Our exposure was the first hospitalized TIA event, ascertained between 1987 and 2020. We report on post-TIA incident events ascertained between 1987 and 2020, including adjudicated dementia, stroke, cardiovascular disease (CVD) events, and mortality. We used Cox proportional hazard regression modeling with TIA as a time-dependent exposure to estimate associations with outcome events. Models were adjusted for demographics and vascular risk factors. RESULTS: The ARIC study enrolled 15,792 participants (27% Black) aged 45-64 years. Our analytic sample included 13,721 participants (mean age 54 years, 55.5% women) who were without history of hospitalized TIAs or the outcomes of interest at baseline. There were 536 hospitalized TIAs over a median of 29 years. Incident dementia risk almost doubled after TIA (hazard ratio [HR] 1.96; 95% CI 1.66-2.31). Participants who had a TIA were at high risk of stroke (8.14; 6.87-9.64) and CVD (1.52; 1.28-1.82) compar...