Data from: Progression of cognitive decline before and after incident stroke

Objective: To determine the trajectory of cognitive decline before and after incident stroke. Methods: By using data from the English Longitudinal Study of Ageing, we studied 9278 nondemented participants with no history of stroke who underwent cognitive assessment at baseline (wave 1), and at least one other timepoint (waves 2 to 7). We used linear mixed models to analyze repeated measures and longitudinal data. Results: Among the 9278 participants (56.8% women, mean age 63.1±10.3 years), 471 (5.1%) incident stroke events were identified. Compared with stroke-free participants, multivariable-adjusted rates of prestroke cognitive decline in global cognition, memory, semantic fluency, and temporal orientation of participants who later experienced an incident stroke were increased by −0.029 standard deviation (SD)/year, −0.016 SD/year, −0.022 SD/year, and −0.024 SD/year, respectively. Among the 471 stroke survivors, the multivariable-adjusted acute changes in the four cognitive domains were −0.257 SD, −0.150 SD, −0.121 SD, and −0.272 SD, respectively. In the years following stroke, global cognition declined over time and was steeper than its prestroke slope, i.e. by −0.064 SD/year after multivariable adjustment. The rates of memory, semantic fluency, and temporal orientation decline were −0.046 SD/year, −0.033 SD/year, and −0.037 SD/year, respectively. Conclusions: Accelerated prestroke and poststroke cognitive decline were associated with incident stroke over a follow-up period of 12 years. Attention should be paid to the long-term cognitive problems of stroke survivors, and intervention and management of major vascular risk factors should start from early- or mid-life to reduce the risk of cerebrovascular disease and the associated cognitive impairment