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Brain function link to stroke risk

3 February 2010: New research from Sweden suggests that memory loss and decline in concentration skills could be a sign of increased risk of stroke in older people.

 

The researchers looked at data from 930 men when they were aged 70, who had taken part in a study to identify risk factors for cardiovascular disease (such as heart disease and stroke). The study was population-based (it involved a sample of people from the general public). The researchers wanted to find out how the men’s brain function related to their risk of having a stroke.

The men were asked to carry out three different tests to assess their memory and brain function. These included the Trail Making Test A (TMT-A), which looks at ability to pay attention; the Trail Making Test B (TMT-B), which is used to assess ability to carry out and change a plan; and the Mini-Mental State Examination (MMSE), which doctors commonly use to measure decline in brain function. The researchers then monitored the men over a period of up to 13 and a half years to find out if they went on to have a stroke or a transient ischaemic attack (TIA or ‘mini stroke’).

Over the time period studied, 166 of the men had a stroke or a TIA, with 105 of these having an ischaemic stroke. Ischaemic stroke is the most common type of stroke, which happens when the blood supply to your brain is cut off by a blood clot or lump of fat.

The study found that after taking into account various other factors, such as education and social group, blood pressure, cholesterol and other heart problems, the men’s performance in the TMT-B test was related to their risk of having an ischaemic stroke during the study period. Those men who took longer to complete the TMT-B test were more than three times more likely to have an ischaemic stroke during the study than those who did the test the fastest.

The other two tests – TMT-A and MMSE – were not found to be related to risk of having a stroke.

The researchers, who published their study in the journal Neurology, suggest that the test could be used to identify men who are most at risk from stroke and so would benefit from early treatment aimed at preventing stroke. They note even those people who had only a mild deterioration in brain function in their study and so may not be receiving treatment, were at greater risk for ischaemic stroke.

Dr Sheh Khemka, medical director of Bupa International, said: “This is a good quality study and the results do seem to suggest a link between some aspects of brain function and risk of stroke. However, it doesn’t mean that everyone who experiences memory or concentration difficulties need worry that they will be at increased risk.

“Whether tests on brain function would be a useful way of identifying people who would benefit from treatment to prevent stroke also remains to be seen. There are a number of factors that doctors can currently look at to assess your stroke risk and whether you need preventative treatment – including your blood pressure and cholesterol level, as well as whether you have any heart problems. Always see your doctor if you are worried about your risk of developing stroke.”

Key facts

  • Worldwide, 15 million people a year suffer from stroke. Of these, five million die and another five million are left permanently disabled.
  • The incidence of stroke is declining in many developed countries – mainly because more people are getting the treatment they need for high blood pressure and because fewer people are smoking.
  • There are a number of things you can do to reduce your risk of getting a stroke. These include stopping smoking, eating a healthy, balanced diet, being more active and drinking alcohol in moderation.
  • Visit your doctor to make sure any medical problems you have such as high blood pressure or high cholesterol are well controlled.

Next steps

  • Read the study

    Wiberg B, Lind L, Kilander L, et al. Cognitive function and risk of stroke in elderly men. Neurology 2010;74:379-85. doi: 10.1212/WNL.0b013e3181ccc516

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Always see your doctor if you are worried about your risk of developing stroke

Dr Sneh Khemka

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