Study: Thinking ability and memory decline for years after stroke

According to a major, long-term study from the University of Michigan Health System, having a stroke will accelerate the decline of your thinking ability and your memory for years, suggesting that far more must be done to monitor stroke survivors after incident.

The Research

The research, “Trajectory of Cognitive Decline After Incident Stroke,” can be found in the July issue of the Journal of the American Medical Association.

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Lead Researcher, Deborah Levine, M.D., MPH

The investigation looked at 23,572 people ages 45 and older in the United States of America without any brain impairments. Data for the participants was taken from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort for people who enrolled between 2003 and 2007. Follow-ups were conducted as of March 31, 2015, at which point 515 people in the study group had survived a stroke.

Because the researchers had information on how REGARDS participants think and learn and how that ability changed over time prior to having a stroke, the team was able to establish a baseline through which to compare future tests.

The Results

The study found that stroke was associated with small declines in general cognition, the ability to learn new things, and verbal memory. Ultimately, people who suffered a stroke saw no statistically significant decline in cognitive impairment immediately after a stroke compared to their pre-stroke cognitive decline rate. However, as years go by that post-stroke rate accelerates significantly. The study presented an example showing that “for a 70-year-old black woman with average values for all covariates at baseline, stroke at year 3 was associated with greater incident cognitive impairment: absolute difference of 4.0% (95% CI, −1.2% to 9.2%) at year 3 and 12.4% (95% CI, 7.7% to 17.1%) at year 6.”

What it Means

Lead research, U-M professor Deborah Levine, M.D., M.P.H., spoke with U-M Health System News about the importance of their findings. “Stroke is common, costly, and disabling, and cognitive decline is a major cause of disability in stroke survivors, yet cognitive decline after stroke has not received enough attention. We hope these findings will shine a spotlight on stroke survivors’ long-term cognitive needs.”

As for what this means? Levine said that“[their] results suggest that stroke survivors warrant monitoring for mounting cognitive impairment over the years after the event. Health systems and payers will need to develop cost-effective systems of care that will best manage the long-term needs and cognitive problems of this growing and vulnerable stroke survivor population.”

 

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