The signs of a future stroke may be evident in cognitive tests up to ten years before illness occurs, Dutch researchers report today.
A team led by Dr Kamran Ikram at Erasmus MC, Rotterdam, the Netherlands, looked at the long-term links between cognition and daily functioning before and after stroke.
They analysed test scores from 14,712 participants in the ongoing Rotterdam Study over an average of 12 years and compared the scores against medical records. During this time, 1,662 participants had a first stroke at an average age of 80.
Those who had a stroke showed different scores on cognition and daily functioning to those who did not, many years before stroke diagnosis.
Differences were seen in a number of widely-used cognitive tests including the Mini-Mental State Examination to assess memory problems and dementia severity, as well as the ‘basic’ and ‘instrumental’ activities of daily living tests.
Findings appear in the Journal of Neurology Neurosurgery & Psychiatry today.
The authors conclude: "Patients who had a stroke have steeper declines in cognition and daily functioning up to ten years before their first-ever stroke compared with stroke-free individuals.
"Our findings suggest that accumulating intracerebral pathology, such as cerebral small vessel disease, neurodegeneration, and inflammation, already has a clinical impact before stroke."
The authors suggest there might be tell-tale signs of a raised stroke risk many years in advance, which could highlight possible candidates for prevention trials.
Heshmatollah, A. Long-term trajectories of decline in cognition and daily functioning before and after stroke. Journal of Neurology Neurosurgery & Psychiatry 7 July 2021 doi: 10.1136//jnnp-2021-326043
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