Intravenous thrombolysis therapy and dementia risk in acute ischemic stroke patients: A retrospective cohort study in Taiwan.

Background: Intravenous thrombolysis (IVT) is the standard treatment for acute ischemic stroke (AIS) to improve functional outcomes. Furthermore, AIS is an important risk factor for dementia. Limited evidence has shown the long-term benefit of IVT on dementia in Western countries.

Objective: We aim to investigate the association between IVT and the risk of dementia in acute ischemic stroke patients in Asian population.

Methods: A retrospective cohort study using medical records from a medical center in Taiwan between 2017 and 2022 was conducted. We included acute ischemic stroke patients aged over 55 years old who had not previously been diagnosed with dementia. The primary outcome was incident dementia ascertained through dementia diagnosis in medical records. The inverse probability of treatment-weighted Cox proportional hazard models were used to estimate the association between IVT and incident dementia.

Results: A total of 1471 patients with AIS were included. 939 (63.8%) were male, and the mean age was 70.7 $\pm$ 9.6 years. Among them, 19.1% of patients (n = 281) received IVT. The mean follow-up time was 2.6 $\pm$ 1.7 years. Although not statistically significant, the IVT was associated with a decreased risk of dementia (HR: 0.88 [95%CI 0.54-1.41)]).

Conclusions: The IVT was associated with lower risk of dementia, although not statistically significant, in reducing the incidence of dementia in Asian patients with ischemic stroke. Studies with larger sample sizes will be needed in the future.