The telltale signs of susceptibility to a stroke may appear up to 10 years before the event, research published in the Journal of Neurology, Neurosurgery & Psychiatry suggests.
Stroke patients experienced much steeper declines in cognitive abilities and routine daily functioning, starting about a decade before their first stroke, than people who did not suffer a stroke, the findings showed.
Women, carriers of the APOE gene that is associated with Alzheimer’s disease, and those with fewer academic qualifications seem to be at greatest risk.
The deterioration in cognitive skills and the inability to carry out routine activities of independent daily living, which are common after a stroke, are attributable to a build-up of physiological changes. It is not clear when these changes start.
The researchers repeatedly used accredited tests to assess the cognitive abilities, such as memory, verbal fluency, reaction times, and manual dexterity, of 14,712 participants between 1990 and 2016.
They also assessed participants’ capacity for basic activities of independent daily living, such as washing, eating, and dressing, and more advanced activities, such as managing finances.
Participants’ medical records were then checked to monitor their health until 2018. Each person who had a stroke during the monitoring period was matched with three participants who had not, based on age and sex.
The researchers then plotted the changes in cognition and daily functioning in both sets of participants to include the 10 years before and the 10 years after a stroke.
During an average monitoring period of 12.5 years, 1,662 participants had their first stroke. The average age at which that happened was 80 years.
Analysis of the test score patterns revealed clear differences in cognition and daily functioning between those who had a stroke and those who did not, up to 10 years before the event.
The study's findings suggested that there might be telltale signs for those at high risk of a stroke many years before one happens.
“Our findings demonstrated that future stroke patients start to deviate from stroke-free controls up to 10 years before the acute event, suggesting that individuals with cognitive and functional decline are at a higher risk of stroke and are possible candidates for prevention trials,” the researchers wrote.
“The accelerated decline in cognition and daily functioning before stroke suggests that individuals with future stroke suffer from accumulating intracerebral damage years before the acute event, such as cerebral small vessel disease, neurodegeneration, and inflammation."
