Reitz and colleagues1 reported the results of a very interesting community-based study involving 1271 elderly persons without dementia or cognitive decline in New York, in which a history of stroke was related to a progressive decline in memory and abstract/visuospatial performance, particularly among men and those without an apolipoprotein E ε4 allele. The authors discussed these results as consistent with studies showing an increased risk of Alzheimer disease (AD) in persons with stroke,2 postulating that if stroke is related to a higher risk of AD, it must be related to a decline in memory, and suggesting a degenerative origin for the memory performance decline associated with stroke. In the Italian Longitudinal Study on Aging (ILSA),3 we evaluated 2963 individuals from a population-based sample and found no association between stroke and incident mild cognitive impairment. However, there was a nonsignificant trend for stroke as a risk factor of progression of mild cognitive impairment to dementia, and among those who progressed to dementia, 60% progressed to AD and 33% to vascular dementia. These findings confirm those of Reitz and colleagues suggesting that, in a predementia syndrome with a cognitive pattern similar to AD and with a central role for memory decline, stroke may also influence the rate of progression to dementia both of degenerative or vascular origin.
Panza F, Capurso C, Solfrizzi V. Stroke and Memory Decline: A Question of Degenerative or Vascular Origin. Arch Neurol. 2006;63(9):1347-1348. doi:10.1001/archneur.63.9.1347-b