Information about Stroke, Stroke Risk and Cognitive Thinking

Increasing evidence suggests that stroke and even stroke risk factors are related to cognitive decline.

For example, in a study published in Stroke, researchers assessed stroke risk factors—such as hypertension, diabetes, and smoking—in more than 2,000 men and women to determine their 10-year risk of stroke. The study found that as stroke risk increased, cognitive performance declined, especially in "executive" functions, such as attention, organization, visual-spatial memory, and abstract thinking.

The impact of even tiny strokes on cognitive function has been demonstrated by the renowned Nun Study. Conducted with 678 Catholic sisters ages 75 to 107, this study has provided a rare opportunity to assess dementia risk factors in these women and then link them with physical changes in the brain verified after their deaths.

In the study, nuns whose autopsies showed significant brain evidence of Alzheimer's disease were up to 20 times more likely to have shown symptoms of dementia when they were alive if they also had brain evidence of tiny strokes. This suggests that coexisting stroke-related (or vascular) damage in the brain heightens the impact of Alzheimer's on cognitive function.

A report from the Archives of Neurology further showed that people with a history of full-blown stroke were about 60 percent more likely to receive a diagnosis of Alzheimer's disease than were those with no history of stroke. The study's authors speculated that the vascular diseases that cause stroke may also contribute to the development of Alzheimer's, or that stroke may hasten the onset of Alzheimer's symptoms in people who are predisposed to developing dementia.

Losing excess weight, making sure to eat a healthy diet, engaging in regular aerobic exercise, and quitting smoking lowers the risk of stroke (and heart disease). Medication may be needed to control blood pressure, cholesterol levels, and diabetes.

In addition, antiplatelet therapy (such as aspirin) or anticoagulants (such as warfarin [Coumadin]) may be necessary for individuals who have already had a stroke or are at high risk for having one.

Publication Review By: Peter V. Rabins, M.D., M.P.H.

Published: 08 Mar 2011

Last Modified: 28 Jan 2015