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Does Stroke Contribute to Racial Differences in Cognitive Decline?

Deborah A Levine1, Mohammed Kabeto2, Kenneth M Langa2

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Stroke
|May 23, 2015
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Summary

Racial differences in cognitive decline among older adults are not explained by stroke incidence or its impact. Incident stroke affects cognition similarly across races, not accounting for disparities in cognitive aging.

Keywords:
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Area of Science:

  • Neuroscience
  • Gerontology
  • Public Health

Background:

  • Blacks exhibit an elevated risk for dementia compared to whites.
  • The underlying reasons for this disparity, including stroke's role, remain unclear.

Purpose of the Study:

  • To investigate if racial differences in cognitive decline are attributed to stroke frequency or impact.
  • To examine the influence of incident stroke on cognitive health in Black and White older adults, controlling for baseline cognition.

Main Methods:

  • Analysis of 4908 Black and White participants (≥65 years) from the Health and Retirement Study (1998-2010).
  • Longitudinal assessment of global cognition using a modified Telephone Interview for Cognitive Status.
  • Linear mixed-effects models were used to adjust for demographics, clinical factors, and time-dependent incident stroke.

Main Results:

  • Incident stroke occurred in 7.5% of Blacks and 6.7% of Whites (P=0.53).
  • Blacks experienced greater cognitive decline than whites (adjusted difference: 1.47 points).
  • This disparity persisted after adjusting for stroke incidence, and stroke impacted cognition similarly across races.

Conclusions:

  • Incident stroke does not explain the observed racial differences in cognitive decline among older adults.
  • The impact of stroke on cognitive function is comparable between Black and White individuals.