Patients with stroke have an increased risk of dementia. Some studies have found that outpatient rehabilitation programs may improve cognitive function in chronic stroke patients. However, little is known about the use of rehabilitation in the outpatient setting and its impact on the risk of dementia. The objective of this study was to examine the association between the intensity of outpatient rehabilitation services received and the risk of dementia.

We used the National Health Insurance Research Database in Taiwan to identify 16,264 patients diagnosed with stroke from 1997 to 2005. Rehabilitation intensity was categorized as none, low, medium or high based on the sum of physical therapy, occupational therapy, and speech therapy within the first 6 months after discharge from inpatient rehabilitation. Cox proportional hazard regression models were used to evaluate the association between the intensity of rehabilitation and the risk of dementia.

During the follow-up period (median, 7.5 years), 1429 patients were diagnosed with incident dementia. Compared to patients in the no rehabilitation group, those who received high intensity therapy had a decreased risk of dementia during the follow-up period (hazard ratio: 0.68; 95% confidence interval: 0.56–0.84). The results remained consistent in analyses stratified by gender.

The intensity of outpatient rehabilitation therapy and the risk of dementia was significantly inversely related in the ischemic stroke patients. Thus, further programs aimed at promoting greater use of outpatient rehabilitation services in patients with stroke are warranted.