The Predictors and Long-Term Trajectory of Poststroke Cognitive Decline study is a completed National Institutes of Health (NIH) / National Institute on Aging (NIA)-funded study (K23AG040278; principal investigator, Deborah Levine) that aimed to determine the predictors and long-term trajectory of cognitive decline after stroke.
This study has advanced the science of vascular cognitive impairment by improving our understanding of post-stroke cognitive impairment trajectory and predictors. For the first time, this study showed that stroke is associated with an acute decline in cognition and also accelerated and persistent cognitive decline over several years, published in JAMA. The study used data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study and linear mixed-effect models to measure changes in cognitive function over time. The editorial praised the “novel” methods, the “clinically meaningful” results, and the research for serving as “a catalyst for future targeted investigations.”
The study identified risk factors for post-stroke cognitive decline using data from the REGARDS cohort, published in Stroke. The results suggested that race, sex, geography, and hypertension status might modify the risk of poststroke cognitive decline. Faster declines in cognition over years after stroke were greater in survivors who were older or had a particular type of ischemic stroke, cardioembolic stroke.
The study examined the association between blood pressure and cognition after stroke, published in the Journal of Stroke and Cerebrovascular Disease. In a cross-sectional analysis of data from the Brain Attack Surveillance in Corpus Christi (BASIC) project, stroke survivors’ blood pressure levels were not associated with cognitive performance at 90 days independent of sociodemographic and clinical factors.
Based on this work, the study team received funding for the NIH/NIA-funded STROKE COG study to understand how post-stroke blood pressure, glucose, and lipid levels independently contribute to post-stroke dementia risk.