Older stroke survivors experience immediate and long-term cognitive decline, study finds

Older adults who have a stroke for the first time experience an immediate and long-term decline in their cognitive function, according to the results of a new study. 

Researchers from the Center for Healthy Brain Ageing at the University of New South Wales, Sydney, reviewed 14 population-based cohort studies conducted in 11 countries from 1993 to 2019. The studies included 20,860 community-dwelling older adults with a history of stroke or dementia; the average age was 73. 

The researchers examined global cognition (including language, memory, processing speed and executive function) in older adults who had a stroke for the first time and compared their functioning with older adults who had not previously had a stroke. They found that incident stroke was associated with a significant acute decline in global cognitive function for survivors and a small but significant acceleration in the rate of decline in future years compared with those without a previous stroke. 

“This global collaborative study involving diverse population cohorts of older adults highlights the significant and lasting negative outcomes of stroke on cognition,” the authors wrote. “Incident stroke was associated with acute decline in all cognitive measures, as well as accelerated poststroke decline in global cognition, language, processing speed and executive functioning.”

The findings of the study were published online in JAMA Network Open. The researchers said that their findings could help clinicians better understand the short-term and long-term needs of stroke patients and highlight the importance of targeting potentially modifiable factors —  such as smoking, diabetes and hypertension — that may contribute to stroke risk. 

“Targeting modifiable vascular risk factors at an early stage may reduce the risk of stroke but also subsequent risk of stroke-related cognitive decline and cognitive impairment,” the authors concluded. “Future research should explore how modifying risk factors in midlife or later life could alter cognitive trajectories in individuals with or without incident stroke.”