Cognitive function in adolescence and risk of early-onset stroke
Author: BMJ Group
Published: 2024/06/28
Post type: Observational study – Peer Reviewed: Yeah
Content: Summary – Introduction – Major – Related
Synopsis: After adjusting for diabetes and restricting the age at first stroke to 40, the associations remained significant. Researchers now advocate for screening that extends beyond traditional stroke risk factors. Recent evidence suggests that stroke cases among those younger than 50 are increasing. And about half of all stroke survivors can expect to live with long-term physical and psychological disabilities, the researchers say.
Introduction
A lower level of mental ability during adolescence may be linked to up to a three-fold increased risk of suffering a stroke before age 50, according to research published online in the journal Journal of epidemiology and community health.
Main Summary
The observed associations held true even after accounting for current diabetes and limiting age at first stroke to 40 years, leading the researchers to suggest that more comprehensive assessments beyond traditional stroke risk factors are now needed to prevent disability and death.
Recent data suggest that stroke cases among people under 50 are increasing and about half of stroke survivors can expect to live with long-term physical and psychological disabilities, researchers say.
Lower levels of mental ability in childhood and adolescence (including the ability to concentrate, problem-solve, and learn) have been associated with higher risks of cardiovascular and metabolic diseases later in life. But the results are contradictory, the researchers say.
To strengthen the evidence base, they wanted to find out whether mental ability in adolescence might be associated with an increased risk of early-onset stroke in a nationally representative sample of 1.7 million Israeli youth.
Before beginning military service, Israelis aged 16 to 20 undergo a comprehensive assessment to evaluate their suitability, and this study includes all those assessed between 1987 and 2012.
In addition to weight, blood pressure, and current diabetes, other factors evaluated included educational level, socioeconomic background, and mental ability.
The latter includes tests to measure the ability to understand and execute verbal instructions; verbal abstraction and categorization (word grouping); mathematical ability, concentration and conceptual thinking; Nonverbal abstract reasoning and visual-spatial problem solving.
The results of the study participants were then linked to the Israeli national stroke database, whose mandatory reporting only began in 2014, until the end of 2018, when the first stroke or death was recorded, whichever came first.
The final analysis is based on 1,741,345 individuals, of whom 738,720 (42%) were women. Of the total, 12% (312,769) were rated as having a high level of mental ability, 70% (1,220,514) as having a medium level, and 18% (208,062) as having a low level.
Compared to those whose scores indicated a high level of mental ability, those at the other end of the scale were more likely to be overweight or obese (17% vs. 12%), less likely to have completed secondary education (82% vs. 99). %), and more likely to have lived in a socially and economically disadvantaged neighborhood (35% vs. 19%), all risk factors for cardiovascular disease.
Between 2014 and 2018, 908 cases of stroke were recorded, of which 767 were caused by a blood clot (ischemic) and 141 by a brain hemorrhage (intracerebral hemorrhage).
The mean age of a first stroke was 39.5 years (the maximum age was 50). And 45 people died as a result (5% of all stroke cases), almost two-thirds of whom (62%) did so within 30 days of the episode.
Among those who scored low to average on mental ability, the incidence of both types of stroke was higher, particularly ischemic stroke.
After taking into account potentially influential factors, those with low mental ability were more than 2.5 times more likely to have a stroke before age 50 than those with a high level, while those with a medium level had a 78% more likely to suffer from it.
Of the 767 cases of ischemic stroke, 311 (41%) occurred before age 40 years. After taking potentially influential factors into account, this risk was almost double (96% higher) among those with a medium level of mental ability and more than 3 times higher. higher among those with a low level in adolescence.
The increased risk increased along with the mental ability score, so that for every 1-unit decrease in the score (scale of 1 to 9), the risk increased by 33%. However, when the analysis was based solely on mental ability categories, no such associations emerged for stroke involving brain hemorrhage.
These associations held true even after further analyses, which included consideration of current diabetes and limiting the age of first stroke to 40 years.
This is an observational study and therefore cannot establish cause and effect. The researchers also acknowledge several limitations of their findings, including a lack of information on lifestyle, such as smoking, physical activity, and diet; higher education; and several potentially important social determinants of health.
But they write:
“Without intervention on risk factors in early adulthood, stroke risk accumulates,” they conclude. “Cognitive function may serve as a means of stratifying individuals at increased risk for stroke and for intervention through potential mediators such as health illiteracy, education, and health-related behaviors. Providing early social and health support to individuals with lower cognitive function may be essential to mitigate their elevated risk.”
Attribution/Source(s):
This peer-reviewed publication entitled Study links lower cognitive ability in adolescents with increased risk of stroke before age 50 The editors of Disabled World selected this book for publication because of its relevance to the disabled community. While the content may have been edited for style, clarity, or brevity, its original author was BMJ Group and published on 06/28/2024. For more details or clarifications, you can contact BMJ Group directly on bmj.com Disabled World makes no warranty or endorsement related to this item.
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Cite this page (APA): BMJ Group. (June 28, 2024). A study links lower cognitive ability in adolescents with a higher risk of stroke before age 50. Disabled world. Retrieved June 28, 2024 from www.disabled-world.com/disability/types/cognitive/mental-teens.php
Permanent link: Study links lower cognitive ability in adolescents with increased risk of stroke before age 50: After adjusting for diabetes and restricting the age of first stroke to 40 years, the associations remained significant.
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