Study Finds Lower Cognitive Function in 60-69 Age Group Tied to Higher Future Stroke Risk
By zoeysky // 2026-10-24
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A longitudinal cohort study published in the Journal of the American Heart Association reports that lower cognitive function in adults aged 60 to 69 years is associated with a higher risk of first-time stroke years later. The study examined stroke risk across multiple cognitive domains, including global cognition, episodic memory, and perceptual speed, according to the report [1][2]. The research drew on data from the GAS (Good Aging in Skane) project and Swedish Board of Health and Welfare registries, the study stated. In age-stratified analysis, participants aged 60 to 69 years in the lowest tertile of global cognition had a hazard ratio of 1.86 for future stroke compared with those in the highest tertile, according to the study [2][3]. The authors wrote that the findings raise questions about whether low cognitive function in younger older adults can serve as a marker for increased stroke risk, noting that the association was not observed in older age groups [4][5].

Methods: Swedish Cohort, Cognitive Domains, and Age Stratification

The study used a prospective cohort design from the Swedish National Study on Aging and Care, with baseline waves in 2001, 2007, and 2012. Exclusion criteria included previous stroke or transient ischemic attack, baseline dementia, or no cognitive data, the study stated. Cognitive tests measured episodic memory, perceptual speed, verbal fluency, and selected components of executive function. According to the researchers, scores were divided into age-stratified tertiles representing low, middle, and high performance [1][6]. Cox proportional hazards regression was used to estimate stroke risk, with adjustments for demographic, lifestyle, and vascular factors. Stroke outcomes were extracted from the Swedish National Patient Register using ICD-10 codes for brain hemorrhage, brain infarction, and unspecified stroke, according to the study [7][8].

Results: Age 60-69 and Men Show Strongest Associations

In fully adjusted models for the whole sample, the low tertile of perceptual speed was associated with a higher risk of stroke compared with the high tertile, with a hazard ratio of 1.40 (95% CI, 1.13–1.72), researchers reported. No significant associations were found for global cognition, episodic memory, executive function, or verbal fluency in the whole sample after full adjustment, according to the study [1][4]. Age-stratified analysis showed that participants aged 60 to 69 years in the low tertile of global cognition had a hazard ratio of 1.86 (95% CI, 1.27–2.69). For the same age group, low episodic memory was associated with a hazard ratio of 1.68 (95% CI, 1.21–2.33), and low perceptual speed with a hazard ratio of 1.66 (95% CI, 1.19–2.32), the study reported. A sensitivity analysis by sex found that men aged 60 to 69 years in low tertiles had higher stroke risk for global cognition (HR, 2.11), episodic memory (HR, 2.30), and perceptual speed (HR, 1.77). For women in the same age group, no significant associations were found in fully adjusted models. Competing risk analysis attenuated the whole-sample association for perceptual speed, but results for the 60-69 age group remained confirmed, the report stated [7][4][5].

Prior Findings, Mechanisms, and Limitations

The authors noted that prior meta-analyses have established higher relative stroke risk for people with cognitive impairment, but studies across different cognitive domains are few and inconsistent. They wrote that inconsistencies in episodic memory, executive function, verbal fluency, and perceptual speed findings may partly reflect methodological differences in cognitive tests and composite scores, according to the report [7][6]. The study suggested that cognitive impairment may express preexisting cerebrovascular damage, such as silent brain infarcts, leukoaraiosis, and cerebral microbleeds, which are linked to increased stroke risk. Shared risk factors including hypertension, diabetes, physical inactivity, smoking, and excessive alcohol use may explain some associations, though risks remained after full adjustment in the youngest group, the authors wrote [1][4]. Limitations cited included possible attrition bias in older participants, limited events in some age and sex strata, potential overfitting from many covariates, and missing cognitive data. The authors stated that cognitive testing might be an important screening tool for future cerebrovascular events in the 60-69 age group. They called for future studies using magnetic resonance imaging, biomarkers, stroke subtype analysis, and further age- and sex-specific investigations [1].

Association Primarily Seen in Younger Older Adults

The study concluded that lower cognitive function in global cognition, episodic memory, and perceptual speed among people aged 60 to 69 years is associated with an increased risk of future stroke. They stated that more studies are needed, including magnetic resonance imaging data and analyses of stroke subtypes, to confirm and explain the findings.

References

  1. Lower Cognitive Function in People Aged 60 to 69 Years Is .... https://www.ahajournals.org/doi/abs/10.1161/JAHA.125.048423?af=R
  2. Lower cognitive test scores among adults in their 60s may .... https://newsroom.heart.org/news/lower-cognitive-test-scores-among-adults-in-their-60s-may-signal-higher-future-stroke-risk
  3. Lower cognitive function linked to higher stroke risk in .... https://docguide.com/article/lower-cognitive-function-linked-to-higher-stroke-risk-in-adults-aged-60-to-69-years?article_title=Lower%20cognitive%20function%20linked%20to%20higher%20stroke%20risk%20in%20adults%20aged%2060%20to%2069%20years&article_id=8146424
  4. Lower Cognitive Scores and Stroke Risk: Does Age Matter? - Medscape. https://www.medscape.com/viewarticle/lower-cognitive-scores-and-future-stroke-risk-does-age-2026a100119g
  5. Lower Cognitive Function in People Aged 60 to 69 Years Is .... https://www.imedsource.org/journal/lower_cognitive_function_in_people_aged_60_to_69%E2%80%89years_is_associated_with_future_stroke
  6. Lower Cognitive Function in People Aged 60 to 69 Years Is .... https://www.researchgate.net/publication/415025010_Lower_Cognitive_Function_in_People_Aged_60_to_69_Years_Is_Associated_With_Future_Stroke
  7. Lower Cognitive Function in People Aged 60 to 69 Years Is Associated .... https://pubmed.ncbi.nlm.nih.gov/42813560/
  8. Lower Cognitive Functioning During 60s Linked to Subsequent Stroke Risk. https://www.drugs.com/news/lower-cognitive-functioning-during-60s-linked-subsequent-stroke-risk-131530.html

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