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Christiane Reitz, MD; Jose A. Luchsinger, MD, MPH; Ming-Xin Tang, PhD; Jennifer Manly, PhD; Richard Mayeux, MSc, MD

Arch Neurol. 2006;63:571-576.

Background  There are conflicting data showing that stroke is associated with a higher risk of dementia and a more severe decline in persons with cognitive impairment. However, it remains unclear if cerebrovascular disease is directly related to cognitive decline in the absence of cognitive impairment or dementia.

Objective  To examine the association between stroke and changes in cognitive function over time in elderly persons without dementia at baseline.

Design  The results of neuropsychological tests from several intervals over a 5-year period were clustered into domains of memory, abstract/visuospatial, and language in 1271 elderly persons without dementia or cognitive decline. Stroke was related to the slope of performance in each cognitive domain using generalized estimating equations.

Results  Memory performance declined over time, while abstract/visuospatial and language performance remained stable during the study period. Stroke was associated with a more rapid decline in memory performance, while there was no association between stroke and decline in abstract/visuospatial or language performance. The association between stroke and decline in memory performance was strongest for men and for persons without an APOE4 allele. A significant association between stroke and decline in abstract/visuospatial performance was also observed for persons without the APOE4 allele.

Conclusion  A history of stroke is related to a progressive decline in memory and abstract/visuospatial performance, especially among men and those without an APOE4 allele.

Author Affiliations: The Gertrude H. Sergievsky Center (Drs Reitz, Luchsinger, Tang, Manly, and Mayeux), The Taub Institute for Research on Alzheimer's Disease and the Aging Brain (Drs Luchsinger, Manly, and Mayeux), and Departments of Medicine (Dr Luchsinger), Neurology (Drs Manly and Mayeux), and Psychiatry (Dr Mayeux), Columbia University College of Physicians and Surgeons; and Department of Biostatistics, Mailman School of Public Health, Columbia University (Dr Tang), New York, NY.

RELATED LETTERS

Stroke and Memory Decline: A Question of Degenerative or Vascular Origin
Francesco Panza, Cristiano Capurso, and Vincenzo Solfrizzi
Arch Neurol. 2006;63(9):1347-1348.
EXTRACT | FULL TEXT  

Stroke and Memory Decline: A Question of Degenerative or Vascular Origin—Reply
Christiane Reitz, José A. Luchsinger, and Richard Mayeux
Arch Neurol. 2006;63(9):1348.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Stroke and Memory Decline: A Question of Degenerative or Vascular Origin--Reply
Reitz et al.
Arch Neurol 2006;63:1348-1348.
FULL TEXT  

Stroke and memory decline: a question of degenerative or vascular origin.
Panza et al.
Arch Neurol 2006;63:1347-1348.
FULL TEXT