Adults in their 60s who perform poorly on tests of thinking ability, memory, and information-processing speed may face a substantially higher risk of stroke later in life, according to new research published in the Journal of the American Heart Association. The study, conducted in Sweden and involving nearly 5,000 older adults, adds to growing evidence that cognitive decline and vascular health are intertwined, and it suggests that simple cognitive testing could serve as an early warning system for stroke risk.
Researchers followed 4,912 adults ages 60 to 80+ who had no history of dementia, stroke, or transient ischemic attack. At enrollment, participants completed tests measuring overall thinking ability, memory, processing speed, verbal skills, and problem-solving. Over an average follow-up of 12.3 years, more than 10% (572 participants) experienced a first-time stroke. The researchers then compared stroke risk among those with the lowest cognitive scores to those with the highest.
The findings were striking for the youngest group: among adults ages 60-69, lower overall thinking ability was linked to an 86% higher risk of stroke, lower memory scores to a 68% higher risk, and lower processing speed to a 66% higher risk. These associations remained even after accounting for other health and lifestyle factors. However, the same pattern was not observed in participants ages 70-79 or 80 and older.
Lead author Alice Askemyr, M.D., a geriatrics researcher at Lund University and Skane University Hospital in Malmo, Sweden, explained that the older population is very diverse, with many in their 80s having multiple medical conditions and medications that could confound the relationship. She noted that poor cognitive performance in the 60s might indicate an undetected brain injury. “So-called ‘silent’ brain injuries can affect both cognitive functioning and the future risk of stroke,” Askemyr said. “They affect roughly 70% of adults over age 70, so their effects may be easier to detect among people in their 60s, when such injuries and other factors that can affect cognition, including medical conditions and medications, are less common.”
Elisabeth Breese Marsh, M.D., FAHA, chair of the 2026 American Heart Association Scientific Statement, Brain Health Across the Life Span: A Framework for Future Studies, who was not involved in the study, emphasized that risk factor modification should begin even earlier. “While it is certainly important for people in their 60s, my advice would be that even people in their 40s and 50s need to be focusing on risk factor modification and habits for good overall brain health,” said Marsh, a professor of neurology and director of the Bayview Stroke Center at The Johns Hopkins University School of Medicine. She added that the study supports aggressive management of vascular risk factors in midlife and provides a potential new screening tool to identify those at higher risk.
The American Stroke Association, a division of the American Heart Association, notes that overall health, lifestyle and environment can affect brain health and cognition over time. The study’s implications are significant: cognitive tests, which are inexpensive and non-invasive, could be used to flag individuals who might benefit from early interventions to prevent stroke. However, the observational study cannot prove cause and effect, and the findings may not be generalizable to other countries due to differences in healthcare and lifestyle. The full manuscript is available online, and additional resources include an American Heart Association news release on how Brain health shaped by lifetime mental, physical, environmental and lifestyle factors and another on Older adults’ driving habits offer window into brain health, cognitive decline. For more on stroke prevention, see the American Stroke Association’s Stroke Risk Factors page. The original release is available at www.newmediawire.com.
