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Predictors of survival in African American patients with AD, VaD, or stroke without dementia

From the Division of Epidemiology and Biostatistics (Dr. Freels), School of Public Health, University of Illinois at Chicago; and Center for Stroke Research (Drs. Nyenhuis and Gorelick), Department of Neurological Sciences, Rush-Presbyterian-St. Luke’s Medical Center, Chicago, IL.

Address correspondence and reprint requests to Dr. Sally Freels, UIC School of Public Health, Division of Epidemiology and Biostatistics, 1603 West Taylor # 953 (M/C 923), Chicago, IL 60612-4336; e-mail: sallyf{at}uic.edu

Background: A hospital-based cohort of African American patients in the Chicago area with AD, vascular dementia (VaD), or stroke without dementia (SWD) were followed for up to 7 years.

Objective: To describe and analyze predictors of survival in this cohort.

Methods: Proportional hazards regression models were used to analyze risk of death in 113 patients with AD (53 deaths), 79 patients with VaD (31 deaths), and 56 patients with SWD (14 deaths).

Results: Patients with AD who were older and had more years of education and lower Barthel ADL scores were at higher risk of death. Patients with VaD who were taking antihypertensive medication were at higher risk of death; those who were taking aspirin or antiplatelet/anticoagulant medication were at lower risk of death; and higher diastolic blood pressure was protective against death. Risk factors for death in the SWD group were older age, having ever been a smoker, and history of atrial fibrillation. Differences in survival across the three groups were not significant after adjusting for age and clinical dementia rating.

Conclusions: Results in patients with VaD support the use of antiplatelet therapy for persons with VaD and suggest that optimal blood pressure may be higher in cognitively compromised poststroke patients than persons in the general population.

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