Trends in cognitive function before and after stroke in China

1. A first episode of stroke was found to precipitate an acute decline in cognitive function for adults in China. 

Evidence Rating Level: 2 (Good)

Strokes are a known risk factor for the development of cognitive decline and dementia. Previous research has not addressed whether a degree of cognitive decline may exist prior to stroke or the timeline of decline following stroke. Researchers collected data on 13,311 adults over the age of 45 in China. At baseline, participants had no known stroke history. Their cognition was assessed initially between June 2011 and March 2012, with a subsequent 7-year follow-up period. During this time, 4.6% of participants had a first stroke. When comparing the stroke and stroke-free participants, both groups showed a similar rate of cognitive decline before stroke onset, as expected with aging. In the years following stroke onset, the stroke group had an acute decline in episodic memory (β,−0.123 SD; 95% CI,−0.227 to−0.019; P=0.021) visuospatial abilities (β,−0.169 SD; 95% CI,−0.292 to −0.047; P=0.007), and global cognition (β,−0.135 SD; 95% CI,−0.228 to−0.042; P=0.004), as well as an accelerated rate of decline for calculation, attention, and orientation skills (β,−0.045 SD; 95% CI,−0.073 to−0.017; P=0.001). A notable limitation is that researchers relied on participants’ self-reported experience of stroke, which was not confirmed with medical records. Future research may assess these trends over a longer follow-up period, as well as the effect of multiple strokes on cognitive trajectories.

Click to read the study in BMC Medicine

Image: PD

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