Stroke and Memory Performance in Elderly Persons Without Dementia

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Abstract
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 APO epsilon F4 allele. A significant association between stroke and decline in abstract/visuospatial performance was also observed for persons without the APOE epsilon 4 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 APOE epsilon 4 allele.

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