Comparison of dementia in stroke survivors and patients with parkinson’s disease in Thai subjects.

ABSTRACT

Comparison of dementia in stroke survivors and patients with Parkinson’s disease was done at Siriraj Hospital during 1990-1994. Two hundred and twelve Thai stroke survivors and 132 patients with Parkinson’s disease were enrolled in this study. The mean age of the study groups were 62.78 (SD 11.12) years for stroke survival group and 67.72 (SD 9.12) years for Parkinson’s diseases group. The mean duration of stroke suffering was 2.09 (SD 2.74) years whereas the mean duration of suffering from Parkinson’s disease was 3.5 (SD 3.53) years. All patients of both groups were screened for depression by using Thai Geriatric Depression Scale and patients with Alzheimer’s disease were excluded from the study. Thai Mental State Examination (TMSE) is a standard test used in this study to identify dementia. Seventy stroke patients (33.02%) scored below 23 points (cut-off point for dementia) and 34 patients (25.76%) of Parkinson’s disease scored below 23 points which they were classified as definite dementia. Anyone who scored below 20 points was classified as severe dementia which there were 40 patients (18.88%) in stroke group and 24 patients (18.18%) in Parkinson’s disease group. Patient who scored between 20-22 points was classified as mild to moderate dementia which there were 30 patients (14.15%) in stroke group and 12 patients (9.09%) in Parkinson’s disease group. Fifty-eight patients (27.36%) in stroke group and 37 patients (28.03%) in Parkinson’s disease group scored between 23-25 points and they were classified as borderline dementia. Comparison of the subset of demenyia yesting in TMSE between stroke group and Parkinson's disease group revented no statistically significant difference in any degree of dementia. Subset tests of orientation, language and abstract thinking, and recall seemed to be more affected in Parkinson's disease group whereas subset test of registration was equally impaired in both groups. There were no difference in subset tests of dementia in mild to moderate dementia group of both patients with stroke and Parkinson's disease. In conclusion we could not differentiate pattern of dementia between stroke survivors and patients with Parkinson's disease even they were severely demented.