Higher education linked to faster cognitive decline after stroke

When someone has a stroke, this can speed up the loss of cognitive skills in the coming years.

Survivors of a stroke who have attended a certain level of higher education may have had to deal with a higher education under a study led by Michigan Medicine.

In an analysis of cognitive results for more than 2,000 patients who were seen for a stroke between 1971 and 2019, graduates performed better on initial post-stroke investigations of global cognition, a measure of the general cognitive capacity that comprises mental functions such as memory, attention and processing speed.

Survivors of a stroke who attended every level of higher education, however, had a faster decrease in the functioning of executive power – skills used to manage daily tasks, such as working memory and problem solving – compared to patients with less than a high school diploma.

Brain atrophy occurs over time, regardless of the level of education. Our findings suggest that attending higher education can enable people to maintain greater cognitive capacity until a critical threshold of brain injury is reached after a stroke. At this point, compensation can fail and a rapid cognitive decline occurs. “

Mellanie V. Springer, MD, MS, first author and Thomas H and Susan C Brown Early Career Professor of Neurology at the University of Michigan Medical School

For years, researchers at the level of education regard as a predictor of the cognitive reserve, the ability to maintain higher levels of functioning despite brain injury that occurs during the course of life.

This led Springer and her colleagues to assume that highly educated people would have a slower cognitive decline after a stroke.

The results published in Jama Network Openreflects the opposite.

“Dementia is a greater threat after a first stroke than a new stroke,” said senior author Deborah A. Levine, MD, MPH, Professor of Internal Medicine and Neurology at the UM Medical School.

“We miss treatments that occur or delay or delay after a stroke cognitive decline and dementia. This study increases our understanding and generates potential hypotheses about the causes of cognitive decline after the battle and where patients run higher risks.”

With a higher number of APOE4 -Allele, a genetic risk factor for Alzheimer’s disease, had no influence on the relationship between educational level and cognitive decline after a stroke. The number of strokes that a person suffered also had no influence on the relationship.

This means, Springer notes, that the critical point of brain injury where cognitive compensation fails in the highly educated is not dependent on the underlying genetic risk and can be reached after a single stroke.

“Identifying which regional patients are at the highest risk of cognitive decline will help to focus on future interventions to slow down cognitive decline,” said Springer.