N + 1; Alice Askemyr et al. / Journal of the American Heart Association, 2026
A decline in processing speed—a key cognitive function—in older age is associated with a 40 percent increase in stroke risk. Furthermore, as reported in the Journal of the American Heart Association, low levels of overall cognitive functioning and episodic memory between the ages of 60 and 69 also significantly increase this risk.
In 2021, stroke was the third leading cause of death worldwide. Risk factors for this life-threatening condition include hypertension, diabetes, physical inactivity, smoking, and excessive alcohol consumption. Cognitive impairment is considered a manifestation of pre-existing cerebrovascular disorders, which are also linked to an elevated risk of stroke. Consequently, some researchers believe that a decline in cognitive function could serve as a predictor of stroke. However, few studies have examined the link between specific cognitive impairments and the risk of subsequent stroke.
A team of scientists led by Alice Askemyr from Lund University assessed the risk of a first stroke in older adults with lower levels of various cognitive functions. The study included 4,912 individuals with no history of stroke, transient ischemic attack, or dementia. The study population comprised 2,203 men, and the final sample included 3,094 individuals aged 60–69, 494 aged 70–79, and 1,184 aged 80 or older. Over a mean follow-up period of 12.3 years, 572 participants experienced an initial stroke. After full adjustment, researchers identified a higher risk of stroke among individuals whose perceptual speed fell within the lowest tertile. However, across the entire study population, no significant associations were found when comparing the lowest and highest tertiles of global cognitive function, episodic memory, executive function, and verbal fluency.
Among participants aged 60 to 69—followed for an average of 14.2 years—an elevated stroke risk was observed in association with declining global cognitive ability, as well as with low levels of episodic memory and slow perceptual speed. Sensitivity analysis indicated a slightly increased stroke risk in the overall cohort associated with declines in episodic memory and perceptual speed, though the association was weak. Notably, the likelihood of stroke associated with cognitive decline was higher in men.
The study authors conclude that cognitive function assessment could serve as a valuable screening tool for future cerebrovascular events in this age group. However, further research incorporating magnetic resonance imaging (MRI) data is needed to refine the diagnosis of cerebrovascular diseases.
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