000145657 001__ 145657
000145657 005__ 20250923084442.0
000145657 0247_ $$2doi$$a10.1001/jamanetworkopen.2024.37133
000145657 0248_ $$2sideral$$a140551
000145657 037__ $$aART-2024-140551
000145657 041__ $$aeng
000145657 100__ $$aLo, Jessica W.
000145657 245__ $$aTrajectory of Cognitive Decline Before and After Stroke in 14 Population Cohorts
000145657 260__ $$c2024
000145657 5060_ $$aAccess copy available to the general public$$fUnrestricted
000145657 5203_ $$aImportancePoststroke cognitive impairment is common, but the cognitive trajectory following a first stroke, relative to prestroke cognitive function, remains unclear.ObjectiveTo map the trajectory of cognitive function before any stroke and after stroke in global cognition and in 4 cognitive domains, as well as to compare the cognitive trajectory prestroke in stroke survivors with the trajectory of individuals without incident stroke over follow-up.Design, Setting, and ParticipantsThe study used harmonized and pooled data from 14 population-based cohort studies included in the Cohort Studies of Memory in an International Consortium collaboration. These studies were conducted from 1993 to 2019 across 11 countries among community-dwelling older adults without a history of stroke or dementia. For this study, linear mixed-effects models were used to estimate trajectories of cognitive function poststroke relative to a stroke-free cognitive trajectory. The full model adjusted for demographic and vascular risk factors. Data were analyzed from July 2022 to March 2024.ExposureIncident stroke.Main outcomes and measuresThe primary outcome was global cognition, defined as the standardized average of 4 cognitive domains (language, memory, processing speed, and executive function). Cognitive domain scores were formed by selecting the most commonly administered test within each domain and standardizing the scores.ResultsThe study included 20 860 participants (12 261 [58.8%] female) with a mean (SD) age of 72.9 (8.0) years and follow-up of 7.51 (4.2) years. Incident stroke was associated with a substantial acute decline in global cognition (−0.25 SD; 95% CI, −0.33 to −0.17 SD), the Mini-Mental State Examination, and all cognitive domains (ranging from −0.17 SD to −0.22 SD), as well as accelerated decline in global cognition (−0.038 SD per year; 95% CI, −0.057 to −0.019 SD per year) and all domains except memory (ranging from −0.020 to −0.055 SD per year), relative to a stroke-free cognitive trajectory. There was no significant difference in prestroke slope in stroke survivors compared with the rate of decline in individuals without stroke in all cognitive measures. The mean rate of decline without a previous stroke was −0.049 SD per year (95% CI, −0.051 to −0.047 SD) in global cognition.Conclusions and relevanceIn this cohort study using pooled data from 14 cohorts, incident stroke was associated with acute and accelerated long-term cognitive decline in older stroke survivors.
000145657 536__ $$9info:eu-repo/grantAgreement/ES/DGA-FEDER/B15-17R$$9info:eu-repo/grantAgreement/ES/MINECO-ISCIII/FIS/G03-128$$9info:eu-repo/grantAgreement/ES/MINECO-ISCIII/FIS/01-0255$$9info:eu-repo/grantAgreement/ES/MINECO-ISCIII/FIS/03-0815$$9info:eu-repo/grantAgreement/ES/MINECO-ISCIII/FIS/06-0617$$9info:eu-repo/grantAgreement/ES/MINECO-ISCIII/FIS/12-02254$$9info:eu-repo/grantAgreement/ES/MINECO-ISCIII/FIS/16-00896$$9info:eu-repo/grantAgreement/ES/MINECO-ISCIII/FIS/19-01874$$9info:eu-repo/grantAgreement/ES/MINECO-ISCIII/FIS/94-1562$$9info:eu-repo/grantAgreement/ES/MINECO-ISCIII/FIS/97-1321E$$9info:eu-repo/grantAgreement/ES/MINECO-ISCIII/FIS/98-0103
000145657 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000145657 590__ $$a9.7$$b2024
000145657 592__ $$a3.546$$b2024
000145657 591__ $$aMEDICINE, GENERAL & INTERNAL$$b14 / 332 = 0.042$$c2024$$dQ1$$eT1
000145657 593__ $$aMedicine (miscellaneous)$$c2024$$dQ1
000145657 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000145657 700__ $$aCrawford, John D.
000145657 700__ $$aLipnicki, Darren M.
000145657 700__ $$aLipton, Richard B.
000145657 700__ $$aKatz, Mindy J.
000145657 700__ $$aPreux, Pierre-Marie
000145657 700__ $$aGuerchet, Maëlenn
000145657 700__ $$ad’Orsi, Eleonora
000145657 700__ $$aQuialheiro, Anna
000145657 700__ $$aRech, Cassiano Ricardo
000145657 700__ $$aRitchie, Karen
000145657 700__ $$aSkoog, Ingmar
000145657 700__ $$aNajar, Jenna
000145657 700__ $$aSterner, Therese Rydberg
000145657 700__ $$aRolandi, Elena
000145657 700__ $$aDavin, Annalisa
000145657 700__ $$aRossi, Michele
000145657 700__ $$aRiedel-Heller, Steffi G.
000145657 700__ $$aPabst, Alexander
000145657 700__ $$aRöhr, Susanne
000145657 700__ $$aGanguli, Mary
000145657 700__ $$aJacobsen, Erin
000145657 700__ $$aSnitz, Beth E.
000145657 700__ $$aAnstey, Kaarin J.
000145657 700__ $$aAiello, Allison E.
000145657 700__ $$aBrodaty, Henry
000145657 700__ $$aKochan, Nicole A.
000145657 700__ $$aChen, Yen-Ching
000145657 700__ $$aChen, Jen-Hau
000145657 700__ $$aSanchez-Juan, Pascual
000145657 700__ $$adel Ser, Teodoro
000145657 700__ $$aValentí, Meritxell
000145657 700__ $$0(orcid)0000-0003-3025-8048$$aLobo, Antonio$$uUniversidad de Zaragoza
000145657 700__ $$0(orcid)0000-0003-2284-7862$$aCámara Izquierdo, Concepción de la$$uUniversidad de Zaragoza
000145657 700__ $$0(orcid)0000-0002-1252-2397$$aLobo, Elena$$uUniversidad de Zaragoza
000145657 700__ $$aSachdev, Perminder S.
000145657 7102_ $$11003$$2027$$aUniversidad de Zaragoza$$bDpto. Anatom.Histolog.Humanas$$cArea Anatom.Embriol.Humana
000145657 7102_ $$11007$$2745$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Psiquiatría
000145657 7102_ $$11011$$2615$$aUniversidad de Zaragoza$$bDpto. Microb.Ped.Radio.Sal.Pú.$$cÁrea Medic.Prevent.Salud Públ.
000145657 773__ $$g7, 10 (2024), e2437133$$pJAMA netw. open$$tJAMA network open$$x2574-3805
000145657 8564_ $$s1181226$$uhttps://zaguan.unizar.es/record/145657/files/texto_completo.pdf$$yVersión publicada
000145657 8564_ $$s2404231$$uhttps://zaguan.unizar.es/record/145657/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000145657 909CO $$ooai:zaguan.unizar.es:145657$$particulos$$pdriver
000145657 951__ $$a2025-09-22-14:51:24
000145657 980__ $$aARTICLE