2026 ECNP Congress

PS02-2064

Are severe mental illnesses associated with dementia and ischemic stroke across age groups? findings from the PADRIS-PRESTO Cohort

Michele De Prisco — V. Oliva, R. Sanchez-Valle, E. Parellada, C. Junque, M.J. Marti, A. Bortolozzi, J. Alberch, G. Garrabou, M.V. Sanchez-Vives, A. Giralt, B. Segura, A. Llado, Y. Compta, J. Radua, E. Vieta, D. Hidalgo-Mazzei, G. Anmella · IDIBAPS, Translational Research Programme for Brain Disorders, Barcelona, Spain

2026 ECNP Congress

Introduction

Severe mental illnesses (SMIs) are complex psychiatric conditions associated with high rates of physical comorbidity and premature mortality. Neurological conditions such as dementia and ischemic stroke may contribute to this burden, potentially through shared risk factors including metabolic dysregulation, dyslipidemia, and hypertension. However, the relationship between SMIs and these neurological outcomes across the lifespan remains insufficiently understood.

Aims

Using data from the PADRIS-PRESTO cohort from Catalonia, Spain [1], this study aimed to (a) describe age-specific prevalence patterns of dementia and ischemic stroke among individuals with SMIs compared with controls, and (b) quantify age-stratified odds ratios (ORs) for these outcomes.

Methods

This population-based cross-sectional study used data from the PADRIS-PRESTO cohort, including all individuals who accessed public specialized mental health (i.e., outpatient, emergency, and inpatient care) or primary care services in Catalonia between January 1, 2015, and December 31, 2019, with retrospective follow-up to January 1, 2010. Adults with a lifetime diagnosis of any SMI (i.e., schizophrenia spectrum disorders, major depressive disorder, or bipolar disorder) and individuals without any psychiatric diagnosis (controls) were considered for inclusion. Sociodemographic and clinical characteristics were collected, with age categorized into 10-year groups. Weighted prevalence rates of dementia and ischemic stroke were calculated by age group and diagnostic status. Two logistic regression models were used to estimate associations. The first one (i.e., minimally adjusted model) included SMI status, age group, and their interaction; the second one (i.e., extended model) included the same predictor of the first model, plus socioeconomic status and comorbidity burden. Age-specific ORs were derived from interaction terms.

Summary of Results: Among the whole sample made of 1,421,510 individuals, 694,086 people were included in the final sample (176,870 with SMIs; 517,216 controls). Dementia prevalence in individuals with SMIs was higher across all age groups (median 3.49%; 0.33% at ages 20-29 to 39.51% at ages 90-99) compared with controls (median 0.36%; 0.02% at ages 20-29 to 17.7% at ages 90-99). SMIs were associated with increased ORs of dementia across all age groups, with the strongest association at ages 30-39 (OR = 23.21, 95% CI: 13.74 - 39.10). Ischemic stroke prevalence was also higher in the SMI group (median 5.3%; 0.22% at ages 20-29 to 16.4% at ages 90-99) than in controls (median 2.75%; 0.08% at ages 20-29 to 14.67% at ages 90-99). Elevated ORs of stroke persisted up to ages 70-79, peaking at 40-49 years (OR = 2.99, 95% CI: 2.63 - 3.41).

Conclusion: Individuals with SMIs have consistently higher prevalence and ORs of dementia and ischemic stroke across the lifespan compared with controls. These findings highlight the need for earlier and more systematic neurological and cardiometabolic screening in this population, while future research should support the development of targeted prevention strategies and inform healthcare policies.

References

  1. De Prisco, M., Oliva, V., Fico, G., Mas, A., Valenzuela-Pascual, C., Montejo, L., … & Anmella, G. (2025). The PADRIS-PRESTO cohort: A comprehensive population-based study on mental health in Catalonia. European Psychiatry, 68(1), e144.