A patient's stroke risk profile - which includes high blood pressure, smoking and diabetes - also may be helpful in predicting whether the person will develop memory and thinking problems later in life, a new study shows (Neurology, 77: 1729-36).
Researchers in a study titled Reasons for Geographic and Racial Differences in Stroke (REGARDS) followed 23,752 people with an average age of 64 who were free of stroke and cognitive problems at the start of the study. Participants underwent a Framingham Stroke Risk Profile, which is used to determine a person's risk of stroke by measuring their age, blood pressure, education level, history of heart disease, smoking and diabetes status, left ventricular hypertrophy (a thickening of the heart muscle), and abnormal heart rhythm. After an average of four years of follow-up, 1,907 people had developed memory and thinking problems.
The higher a person's score on the Stroke Risk Profile, the researchers found, the greater the chance of developing cognitive problems four years later. Fifteen percent of people who scored among the highest 25 percent on the test had cognitive problems, compared to 3 percent of those who scored among the bottom 25 percent with a score below 3.4 points.
"Overall, it appears that the total Stroke Risk Profile score, while initially created to predict stroke, is also useful in determining the risk of cognitive problems," said study author Frederick Unverzagt, PhD, of Indiana University School of Medicine in Indianapolis.
The study found older age and the presence of thickening in the heart muscle, which is a result of long-term high blood pressure, were the only Stroke Risk Profile factors independently associated with future cognitive problems. This association remained even after controlling for age, gender, race, geography and education. In addition, the study found high systolic blood pressure was related to cognitive problems in people without a thickening of the heart muscle.
"Our findings suggest that elevated blood pressure and thickening of the heart muscle may provide a simple way for doctors to identify people at risk for memory and thinking problems," said Dr. Unverzagt. "Increased focus on preventing and treating high blood pressure may be needed to preserve cognitive health."
The REGARDS study was supported by the National Institute of Neurological Disorders and Stroke.