Memory slips tied to stroke risk among highly educated

By Andrew M. Seaman

By Andrew M. Seaman (Reuters Health) - Highly educated people who report lapses in memory may be at increased risk of having a stroke, suggests a new study from the Netherlands. Highly educated people who reported noticeable lapses in memory were 39 percent more likely than those without lapses to have a stroke within the next 12 years, researchers report in the journal Stroke. “Persons who complain of cognitive/memory complaints should be monitored not only because of the possibility of incipient dementia, but also for an increased risk of stroke,” Dr. Arfan Ikram from Erasmus University Rotterdam, who led the study, said in an email to Reuters Health. “Important are memory complaints that are more than usual and interfere in one's daily functioning," he added. “This is especially true for highly (educated) people.” For the new study, Ikram and his colleagues used data from 9,152 people who were at least 55 years old. Between 1990 and 1993, or 2000 and 2001, the participants answered questions about memory lapses and completed tests that measure cognitive function. By 2012, there were about 1,200 strokes among the participants. The researchers found that people who reported memory lapses were about 20 percent more likely overall to have strokes during the follow-up period. But that link was isolated among those who reported the most education, meaning university or advanced vocational training. With memory lapses, their stroke risk was 39 percent higher than people without the lapses. Strokes also tended to occur earlier in people with higher levels of education, the researchers found. Broader scores on cognitive functioning were not tied to stroke risk, however. The study can’t explain why the association between memory lapses and stroke only appeared in highly educated people. The researchers write that it could be that highly educated people have more so-called cognitive reserve, which prevents them from noticing memory problems until their risk of stroke is more advanced. Instead of strokes or memory lapses causing each other, one expert not involved with the new study said it’s likely that memory complaints are the result of a condition that also increases the risk of stroke, such as high blood pressure. “As pointed out by the authors, it’s likely the case that in selected people that they have some memory challenges and that is not perhaps directly related to future risk of stroke, but related to other risk factors like high blood pressure,” said Dr. Robert Brown, a neurologist at the Mayo Clinic in Rochester, Minnesota. Brown cautioned that the new report doesn’t mean people should worry if they notice lapses in memory, such as briefly forgetting keys or names. “Every one of us that have a subjective memory complaint will not have a future stroke,” he told Reuters Health. “By no means is it a 100 percent connection between subjective memory complaints and future stroke.” Instead, he said people who are having memory problems that start to affect their lives should see their doctors – especially those with high levels of education. “And their provider may want to make sure their blood pressure is appropriately treated along with any other risk factors that may put them at future risk of stroke,” Brown said. Ikram said the results likely apply to other populations even though the participants in the current study were mostly white. More research is needed to confirm that, as well as to see if the results apply to people in less wealthy nations. SOURCE: Stroke, online December 11, 2014.