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Original Contribution
April 2006

Stroke and Memory Performance in Elderly Persons Without Dementia

Author Affiliations

Author Affiliations: The Gertrude H. Sergievsky Center (Drs Reitz, Luchsinger, Tang, Manly, and Mayeux), The Taub Institute for Research on Alzheimer's Disease and the Aging Brain (Drs Luchsinger, Manly, and Mayeux), and Departments of Medicine (Dr Luchsinger), Neurology (Drs Manly and Mayeux), and Psychiatry (Dr Mayeux), Columbia University College of Physicians and Surgeons; and Department of Biostatistics, Mailman School of Public Health, Columbia University (Dr Tang), New York, NY.

Arch Neurol. 2006;63(4):571-576. doi:10.1001/archneur.63.4.571

Background  There are conflicting data showing that stroke is associated with a higher risk of dementia and a more severe decline in persons with cognitive impairment. However, it remains unclear if cerebrovascular disease is directly related to cognitive decline in the absence of cognitive impairment or dementia.

Objective  To examine the association between stroke and changes in cognitive function over time in elderly persons without dementia at baseline.

Design  The results of neuropsychological tests from several intervals over a 5-year period were clustered into domains of memory, abstract/visuospatial, and language in 1271 elderly persons without dementia or cognitive decline. Stroke was related to the slope of performance in each cognitive domain using generalized estimating equations.

Results  Memory performance declined over time, while abstract/visuospatial and language performance remained stable during the study period. Stroke was associated with a more rapid decline in memory performance, while there was no association between stroke and decline in abstract/visuospatial or language performance. The association between stroke and decline in memory performance was strongest for men and for persons without an APOEε4 allele. A significant association between stroke and decline in abstract/visuospatial performance was also observed for persons without the APOEε4 allele.

Conclusion  A history of stroke is related to a progressive decline in memory and abstract/visuospatial performance, especially among men and those without an APOEε4 allele.