MRI image of brain shown on a tablet
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Stroke survivors who have some level of higher education could face more profound cognitive decline due to a stroke, according to a study published Wednesday in JAMA Network Open.
Researchers evaluated stroke outcomes in 2,019 older adults who experienced a stroke between 1971 and 2019. College graduates did better on initial post-stroke assessments that measured memory, attention and processing speed. People who achieved any level of higher education had faster declines in executive functioning — skills used to manage everyday tasks, such as working memory and problem-solving — compared with those who didn’t attain a high school degree.
Those who had more ApoE4 allele, a genetic risk factor for Alzheimer’s disease, did not have an effect on the link between education level and cognitive decline after stroke. The number of strokes a person had did not affect that relationship either nor did age, the data showed.
The team looked at four education classifications: attaining less than high school, completing high school, attending some college, and graduating from college.
Brain atrophy occurs over time regardless of how much education a person receives, they found, but being more educated may allow people to gain greater cognitive ability. When they incur a brain injury such as stroke, the rapid decline can occur, Mellanie V. Springer, MD, an author and professor of neurology at University of Michigan Medical School, said in a statement.
“We lack treatments that prevent or slow cognitive decline and dementia after stroke. This study increases our understanding and generates potential hypotheses about the causes of post-stroke cognitive decline and which patients face higher risks of it,” senior author Deborah A. Levine, MD, a professor of internal medicine and neurology at U-M Medical School, added.
In a related study published Wednesday in JAMA, investigators found that people who had a transient ischemic attack or minor stroke had a high risk of subsequent stroke.