Higher Education Level Tied to Decline in Executive Function After Stroke

THURSDAY, April 3, 2025 (HealthDay News) — Stroke survivors with a higher education level have a steeper decline in executive function, according to a study published online March 26 in JAMA Network Open.

Mellanie V. Springer, M.D., from the University of Michigan in Ann Arbor, and colleagues examined the association of education level with poststroke cognitive decline in an individual participant data meta-analysis of four U.S. cohort studies. The analysis included 2,019 initially dementia-free stroke survivors: 16.7, 30.4, 24.0, and 28.9 percent had less than a high school education, had completed high school, had some college, and had a college degree or higher, respectively. Median follow-up time after stroke was 4.1 years.

The researchers found that college graduates had higher initial poststroke performance in global cognition, executive function, and memory compared with those with less than a high school degree (1.09, 1.81, and 0.99 points higher, respectively). The decline in executive function was faster among college graduates and those with some college education compared with stroke survivors with less than a high school education (–0.44 and –0.30 points/year faster, respectively). There was no association for education level with declines in global cognition or memory. The association of education with cognitive decline was not modified by age.

“Higher education level may be associated with faster cognitive decline after stroke. In designing interventions to slow cognitive decline after stroke, researchers should consider evaluating whether the efficacy of such interventions [varies] by education level,” the authors write.

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