Lower Cognitive Function in People Aged 60 to 69 Years Is Associated With Future Stroke

BACKGROUND: The association between impairment across cognitive domains and incident stroke has not been thoroughly investigated. This study examined the risk of first-time stroke among older adults with lower cognitive function in different cognitive domains and how associations vary by age. METHODS: This longitudinal cohort study used baseline data from GÅS (Good Aging in Skåne) and registry data from the Swedish Board of Health and Welfare. Exclusion criteria were previous stroke or transient ischemic attack, baseline dementia, or no cognitive data. The participants (n=4912) were divided into tertiles on the basis of performance on cognitive tests representing multiple cognitive domains. Cox regression was used to estimate the risk of stroke for the low tertile of cognitive function compared with the high tertile. Age-stratified analysis was performed for participants aged 60 to 69, 70 to 79, and ≥80 years. RESULTS: The studied population consisted of 2203 men, 3094 aged 60 to 69 years, 494 aged 70 to 79 years, and 1184 aged ≥80 years. During the average follow-up time of 12.3 years, 572 of the 4912 participants had a stroke. In the fully adjusted models, participants in the low tertile of perceptual speed had higher risk of stroke (hazard ratio [HR], 1.40 [95% CI, 1.13-1.72]). In age-stratified analysis, higher risk of stroke was observed for participants aged 60 to 69 years in the low tertile of global cognition (HR, 1.86 [95% CI, 1.27-2.69]), episodic memory (HR, 1.68 [95% CI, 1.21-2.33]), and perceptual speed (HR, 1.66 [95% CI, 1.19-2.32]). CONCLUSIONS: Lower cognitive functioning in global cognition, episodic memory and perceptual speed in people aged 60 to 69 years are associated with an increased risk of future stroke.