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Potential Value of Impaired Cognition in Stroke Prediction: A U.K. Population-Based Study

Published version
Peer-reviewed

Type

Article

Change log

Authors

Stephan, BCM 
Richardson, K 
Savva, GM 
Matthews, FE 

Abstract

Objectives

To determine whether the association between impaired cognition and greater risk of incident stroke is also observed when cognitive impairment is defined using different criteria for mild cognitive impairment (MCI).

Design

Prospective cohort study with 10 years of follow-up.

Setting

Large multicentre study in the United Kingdom.

Participants

Individuals (aged 64–105) from the Medical Research Council Cognitive Function and Ageing Study (N = 13,004). From this, a subsample of 2,640 individuals was selected based on age, center, and cognitive ability to undergo a detailed cognitive assessment.

Measurements

Information on sociodemographic characteristics, health, cognition, and functional ability was collected in an interview. The Geriatric Mental State Automated Geriatric Examination for Computer Assisted Taxonomy and the Cambridge Cognitive Examination were used to determine cognitive status. Stroke incidence was derived from self-report, informant report, and death certificates. Participants were divided into no, mild, moderate, and severe cognitive impairment according to their baseline Mini-Mental State Examination (MMSE) score. MCI criteria were used to classify persons into four groups: no cognitive impairment, MCI, severe impairment (i.e. other cognitive impairment no dementia: OCIND) and dementia.

Results

Over 10 years, 703 incident strokes occurred. Lower MMSE score at baseline was associated with greater risk of incident stroke. When cognitive status was determined according to MCI criteria, those with severe impairment (odds ratio (OR) = 1.5, 95% confidence interval (CI) = 1.0–2.2) and dementia (OR = 2.6, 95% CI = 1.6–3.4) had a significantly greater risk of stroke than those with no cognitive impairment.

Conclusion

Criteria for MCI, defined using MMSE scores or clinical criteria, can capture individuals at greater stroke risk. The results highlight the need to focus on stroke risk in individuals even with MCI.

Description

Keywords

mild cognitive impairment (MCI), stroke, cognitive aging, cohort studies, risk factors in epidemiology

Journal Title

Journal of the American Geriatrics Society

Conference Name

Journal ISSN

0002-8614
1532-5415

Volume Title

Publisher

Wiley
Sponsorship
Medical Research Council (G9901400)
Medical Research Council (G0701539)
Study funded by the Medical Research Council (G9901400) and Department of Health. BCMS was supported by a European Research Area in Ageing Future Leaders of Ageing Research in Europe postdoctoral fellowship (MRC Grant Reference G0701539).