Trajectory of Cognitive Decline Before and After Stroke in 14 Population Cohorts

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dc.citation.issue10
dc.citation.volume7
dc.contributor.authorLo JW
dc.contributor.authorCrawford JD
dc.contributor.authorLipnicki DM
dc.contributor.authorLipton RB
dc.contributor.authorKatz MJ
dc.contributor.authorPreux P-M
dc.contributor.authorGuerchet M
dc.contributor.authord'Orsi E
dc.contributor.authorQuialheiro A
dc.contributor.authorRech CR
dc.contributor.authorRitchie K
dc.contributor.authorSkoog I
dc.contributor.authorNajar J
dc.contributor.authorSterner TR
dc.contributor.authorRolandi E
dc.contributor.authorDavin A
dc.contributor.authorRossi M
dc.contributor.authorRiedel-Heller SG
dc.contributor.authorPabst A
dc.contributor.authorRöhr S
dc.contributor.authorGanguli M
dc.contributor.authorJacobsen E
dc.contributor.authorSnitz BE
dc.contributor.authorAnstey KJ
dc.contributor.authorAiello AE
dc.contributor.authorBrodaty H
dc.contributor.authorKochan NA
dc.contributor.authorChen Y-C
dc.contributor.authorChen J-H
dc.contributor.authorSanchez-Juan P
dc.contributor.authorDel Ser T
dc.contributor.authorValentí M
dc.contributor.authorLobo A
dc.contributor.authorDe-la-Cámara C
dc.contributor.authorLobo E
dc.contributor.authorSachdev PS
dc.coverage.spatialUnited States
dc.date.accessioned2024-11-03T20:29:48Z
dc.date.available2024-11-03T20:29:48Z
dc.date.issued2024-10-02
dc.description.abstractIMPORTANCE: Poststroke cognitive impairment is common, but the cognitive trajectory following a first stroke, relative to prestroke cognitive function, remains unclear. OBJECTIVE: To map the trajectory of cognitive function before any stroke and after stroke in global cognition and in 4 cognitive domains, as well as to compare the cognitive trajectory prestroke in stroke survivors with the trajectory of individuals without incident stroke over follow-up. DESIGN, SETTING, AND PARTICIPANTS: The study used harmonized and pooled data from 14 population-based cohort studies included in the Cohort Studies of Memory in an International Consortium collaboration. These studies were conducted from 1993 to 2019 across 11 countries among community-dwelling older adults without a history of stroke or dementia. For this study, linear mixed-effects models were used to estimate trajectories of cognitive function poststroke relative to a stroke-free cognitive trajectory. The full model adjusted for demographic and vascular risk factors. Data were analyzed from July 2022 to March 2024. EXPOSURE: Incident stroke. MAIN OUTCOMES AND MEASURES: The primary outcome was global cognition, defined as the standardized average of 4 cognitive domains (language, memory, processing speed, and executive function). Cognitive domain scores were formed by selecting the most commonly administered test within each domain and standardizing the scores. RESULTS: The study included 20 860 participants (12 261 [58.8%] female) with a mean (SD) age of 72.9 (8.0) years and follow-up of 7.51 (4.2) years. Incident stroke was associated with a substantial acute decline in global cognition (-0.25 SD; 95% CI, -0.33 to -0.17 SD), the Mini-Mental State Examination, and all cognitive domains (ranging from -0.17 SD to -0.22 SD), as well as accelerated decline in global cognition (-0.038 SD per year; 95% CI, -0.057 to -0.019 SD per year) and all domains except memory (ranging from -0.020 to -0.055 SD per year), relative to a stroke-free cognitive trajectory. There was no significant difference in prestroke slope in stroke survivors compared with the rate of decline in individuals without stroke in all cognitive measures. The mean rate of decline without a previous stroke was -0.049 SD per year (95% CI, -0.051 to -0.047 SD) in global cognition. CONCLUSIONS AND RELEVANCE: In this cohort study using pooled data from 14 cohorts, incident stroke was associated with acute and accelerated long-term cognitive decline in older stroke survivors.
dc.description.confidentialfalse
dc.edition.edition2024
dc.format.paginatione2437133-
dc.identifier.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/39356504
dc.identifier.citationLo JW, Crawford JD, Lipnicki DM, Lipton RB, Katz MJ, Preux P-M, Guerchet M, d'Orsi E, Quialheiro A, Rech CR, Ritchie K, Skoog I, Najar J, Sterner TR, Rolandi E, Davin A, Rossi M, Riedel-Heller SG, Pabst A, Röhr S, Ganguli M, Jacobsen E, Snitz BE, Anstey KJ, Aiello AE, Brodaty H, Kochan NA, Chen Y-C, Chen J-H, Sanchez-Juan P, Del Ser T, Valentí M, Lobo A, De-la-Cámara C, Lobo E, Sachdev PS. (2024). Trajectory of Cognitive Decline Before and After Stroke in 14 Population Cohorts.. JAMA Netw Open. 7. 10. (pp. e2437133-).
dc.identifier.doi10.1001/jamanetworkopen.2024.37133
dc.identifier.eissn2574-3805
dc.identifier.elements-typejournal-article
dc.identifier.issn2574-3805
dc.identifier.numbere2437133
dc.identifier.pii2824331
dc.identifier.urihttps://mro.massey.ac.nz/handle/10179/71893
dc.languageeng
dc.publisherAmerican Medical Association
dc.publisher.urihttps://jamanetwork.com/journals/jamanetworkopen/fullarticle/2824331#nav
dc.relation.isPartOfJAMA Netw Open
dc.rights(c) 2024 Lo JW et al. JAMA Network Open.
dc.rightsCC BY 4.0
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectHumans
dc.subjectFemale
dc.subjectMale
dc.subjectAged
dc.subjectCognitive Dysfunction
dc.subjectStroke
dc.subjectCohort Studies
dc.subjectAged, 80 and over
dc.subjectCognition
dc.subjectMiddle Aged
dc.subjectRisk Factors
dc.titleTrajectory of Cognitive Decline Before and After Stroke in 14 Population Cohorts
dc.typeJournal article
pubs.elements-id491907
pubs.organisational-groupOther
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