Evidence seen for dose-response association, with 33 percent increased risk for one-unit lower cognitive function
FRIDAY, June 28, 2024 (HealthDay News) — Lower cognitive function in adolescence is associated with increased risk of early-onset stroke, according to a study published online June 27 in the Journal of Epidemiology & Community Health.
Aya Bardugo, M.D., from the Hebrew University in Jerusalem, and colleagues examined the association between adolescent cognitive function and early-onset stroke in a nationwide population-based cohort study of 1,741,345 Israeli adolescents (42 percent women) who underwent comprehensive cognitive function tests at age 16 to 20 years during 1987 to 2012. Cognitive function was categorized as low (1 to 3), medium (4 to 7), or high (8 to 9) (corresponding to IQ scores <89, 89 to 118, and >118, respectively).
During 8,689,329 person-years of follow-up up to a maximum of 50 years, the researchers identified 908 first stroke events (767 ischemic and 141 hemorrhagic). Body mass index-adjusted and sociodemographic-adjusted hazard ratios for early onset stroke were 1.78 and 2.68 in the medium and low versus high cognitive function groups, respectively. Evidence of a dose-response relationship was seen, with a one-unit lower cognitive function z-score associated with a 33 percent increased stroke risk. In sensitivity analyses that accounted for diabetes status and hypertension, these associations were similar for ischemic stroke, but lower for hemorrhagic stroke.
“Our findings support the addition of cognitive function to the more traditional stroke risk factors, to provide more effective health education and health care,” the authors write.
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