BACKGROUND AND PURPOSE: Vascular disorders that increase risk for stroke may be accompanied by decrements in cognitive functioning and by stroke symptoms in the absence of diagnosed stroke or transient ischemic attack. This study evaluates relationships among cognitive status, stroke symptom reports, and cardiovascular and behavioral factors. METHODS: REasons for Geographic and Racial Differences in Stroke (REGARDS), a prospective population study of stroke incidence, assesses stroke risk with telephone interviews and in-home physicals. Excluding subjects with a history of stroke or transient ischemic attack, this analysis includes 14,566 black and white men and women > or =45 years of age. Incremental logistic models examine baseline relationships among cognitive status (Six-item Screener scores), stroke symptom reports, demographics, health behaviors, cardiovascular indices, and depressive symptoms. RESULTS: A history of stroke symptoms was related to impaired cognitive status after adjusting for age, gender, race, and education but not after adjusting for poor health behaviors, vascular risk factors, and depressive symptoms. Odds of experiencing a stroke symptom increased 35% with each of five modifiable factors (hypertension, diabetes, smoking, lack of exercise, depressive symptoms), and odds of cognitive impairment increased an additional 12% with each modifiable factor. Lifelong abstinence from alcohol, lack of exercise, and depressive symptoms were independently related to impaired cognitive status. CONCLUSIONS: The increased likelihood of cognitive impairment among subjects reporting stroke symptoms in the absence of a diagnosed stroke or transient ischemic attack suggests that such symptoms are not benign and may warrant clinical evaluation that includes a cognitive assessment. Future studies that include brain imaging may clarify the etiology of these symptoms.
BACKGROUND AND PURPOSE:Vascular disorders that increase risk for stroke may be accompanied by decrements in cognitive functioning and by stroke symptoms in the absence of diagnosed stroke or transient ischemic attack. This study evaluates relationships among cognitive status, stroke symptom reports, and cardiovascular and behavioral factors. METHODS: REasons for Geographic and Racial Differences in Stroke (REGARDS), a prospective population study of stroke incidence, assesses stroke risk with telephone interviews and in-home physicals. Excluding subjects with a history of stroke or transient ischemic attack, this analysis includes 14,566 black and white men and women > or =45 years of age. Incremental logistic models examine baseline relationships among cognitive status (Six-item Screener scores), stroke symptom reports, demographics, health behaviors, cardiovascular indices, and depressive symptoms. RESULTS: A history of stroke symptoms was related to impaired cognitive status after adjusting for age, gender, race, and education but not after adjusting for poor health behaviors, vascular risk factors, and depressive symptoms. Odds of experiencing a stroke symptom increased 35% with each of five modifiable factors (hypertension, diabetes, smoking, lack of exercise, depressive symptoms), and odds of cognitive impairment increased an additional 12% with each modifiable factor. Lifelong abstinence from alcohol, lack of exercise, and depressive symptoms were independently related to impaired cognitive status. CONCLUSIONS: The increased likelihood of cognitive impairment among subjects reporting stroke symptoms in the absence of a diagnosed stroke or transient ischemic attack suggests that such symptoms are not benign and may warrant clinical evaluation that includes a cognitive assessment. Future studies that include brain imaging may clarify the etiology of these symptoms.
Authors: Usman Baber; Virginia J Howard; Jonathan L Halperin; Elsayed Z Soliman; Xiao Zhang; William McClellan; David G Warnock; Paul Muntner Journal: Circ Arrhythm Electrophysiol Date: 2010-11-13
Authors: Daniel Woo; Jonathan Rosand; Chelsea Kidwell; Jacob L McCauley; Jennifer Osborne; Mark W Brown; Sandra E West; Eric W Rademacher; Salina Waddy; Jamie N Roberts; Sebastian Koch; Nicole R Gonzales; Gene Sung; Steven J Kittner; Lee Birnbaum; Michael Frankel; Fernando Daniel Testai; Christiana E Hall; Mitchell S V Elkind; Matthew Flaherty; Bruce Coull; Ji Y Chong; Tanya Warwick; Marc Malkoff; Michael L James; Latisha K Ali; Bradford B Worrall; Floyd Jones; Tiffany Watson; Anne Leonard; Rebecca Martinez; Ralph I Sacco; Carl D Langefeld Journal: Stroke Date: 2013-09-10 Impact factor: 7.914
Authors: F W Unverzagt; L A McClure; V G Wadley; N S Jenny; R C Go; M Cushman; B M Kissela; B J Kelley; R Kennedy; C S Moy; V Howard; G Howard Journal: Neurology Date: 2011-11-08 Impact factor: 9.910
Authors: Brian R Christie; Brennan D Eadie; Timal S Kannangara; Julie M Robillard; James Shin; Andrea K Titterness Journal: Neuromolecular Med Date: 2008-06-06 Impact factor: 3.843
Authors: Shia T Kent; Leslie A McClure; Suzanne E Judd; Virginia J Howard; William L Crosson; Mohammad Z Al-Hamdan; Virginia G Wadley; Fredrick Peace; Edmond K Kabagambe Journal: Ann Neurol Date: 2012-12-07 Impact factor: 10.422
Authors: Patrick M Pullicino; Leslie A McClure; Virginia G Wadley; Ali Ahmed; Virginia J Howard; George Howard; Monika M Safford Journal: Stroke Date: 2009-10-15 Impact factor: 7.914
Authors: Shia T Kent; Leslie A McClure; William L Crosson; Donna K Arnett; Virginia G Wadley; Nalini Sathiakumar Journal: Environ Health Date: 2009-07-28 Impact factor: 5.984