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, followed nearly 5,000 older adults without dementia or prior stroke and found that those with the lowest cognitive scores in their 60s had up to an 86% higher risk of a first-time stroke over an average of 12 years.
Researchers from Lund University and Skane University Hospital in Malmo analyzed data from the Good Aging in Skane project, including 4,912 participants aged 60 to 80+. Cognitive function was assessed using standardized tests of memory, processing speed, verbal fluency, and executive function. During follow-up, 572 participants had a stroke. Among those aged 60–69, lower overall thinking ability was linked to an 86% higher stroke risk, lower memory scores to a 68% higher risk, and slower processing speed to a 66% higher risk. These associations were not seen in participants aged 70–79 or 80 and older after adjusting for other health and lifestyle factors.
Lead author Alice Askemyr, M.D., a geriatrics researcher at Lund University, explained that the age differences may reflect the accumulation of health conditions in older age. "We chose to investigate different age spans because the older population is very diverse," she said. "What serves as a risk factor in early life might not serve as one if it is acquired later in life and vice versa." She also noted that poor cognitive performance in the younger group could signal 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."
The findings suggest that simple cognitive testing in midlife could serve as a new screening tool to identify individuals at higher risk of stroke. 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. "This study, in conjunction with others, supports how important it is to be aggressive in managing vascular risk factors and focusing on brain health in midlife, before many people typically begin to think about it," Marsh said. "This would improve both cognitive performance and stroke risk in older age."
According to the American Stroke Association, a division of the American Heart Association, overall health, lifestyle and environment can affect brain health and cognition over time. The study's observational design means it cannot prove cause and effect, and results may not be generalizable to other countries due to differences in healthcare and lifestyle. The full manuscript is available online, and additional resources include the American Heart Association news release Brain health shaped by lifetime mental, physical, environmental and lifestyle factors and information on Stroke Risk Factors. The original release can be viewed at www.newmediawire.com.
