Stroke rehabilitation is associated with a reduction in dementia risk: A population-based retrospective cohort study

Objective: Focusing on the relationship between physical activity and incident cognitive impairment, the aim of this study was to investigate whether stroke rehabilitation reduces the risk of dementia. Methods: Claims data of 1,000,000 insured subjects randomly selected from the National Health Insurance programme of Taiwan were used to identify adults with a newly diagnosed ischaemic stroke in 1997-2002. Among them, 1,375 received rehabilitation and 3,722 did not. Both groups were followed up until the end of 2007 to measure the incidence of development of dementia. Results: The incidence of development of dementia was lower in the rehabilitation cohort than in the non-rehabilitation cohort (1.22 vs 1.70 per 100 person-years), with an adjusted hazard ratio (HR) of 0.73 (95% confidence interval (CI) = 0.60-0.89) in the multivariate Cox proportional hazard regression analysis. Female gender (HR = 1.26, 95% CI = 1.07-1.50), older age (HR = 7.71, 95% CI = 3.36-17.7), low income (HR = 1.82, 95% CI = 1.42-2.33), and Parkinson's disease (HR = 1.64, 95% CI = 1.33-2.03) were risk factors associated with the development of dementia. Conclusion: Post-stroke rehabilitation is associated with a reduction in dementia risk among ischaemic stroke patients.