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In a Swedish study, adults ages 60–69 with lower scores in overall thinking, memory or processing speed had higher rates of first-time stroke during follow-up. Researchers did not find the same pattern among participants ages 70 and older, and the observational study cannot show that lower cognitive scores cause strokes.
A Swedish study found that adults ages 60 to 69 with lower scores on tests of thinking ability, memory and information-processing speed were more likely to have a first-time stroke during follow-up. The findings, published in the Journal of the American Heart Association, show an association; they do not establish that lower cognitive performance causes stroke.
The research included 4,912 adults aged 60 and older enrolled in the Good Aging in Skåne project. Participants had no history of dementia, stroke or transient ischemic attack when included. Researchers assessed memory, processing speed, verbal fluency and executive function using standardized tests, and grouped scores by age as low, middle or high. Overall thinking ability was estimated from available test results.
Over an average 12.3 years of follow-up, 572 participants—more than 10% of the study group—had a first stroke. For adults ages 60–69, those with the lowest overall thinking scores had an estimated 86% higher stroke risk than those with the highest scores. Lower memory scores were associated with a 68% higher risk, and lower processing-speed scores with a 66% higher risk.
The same pattern was not found among participants ages 70–79 or 80 and older after researchers accounted for other health and lifestyle factors. The study used Swedish health data collected from 2001 to 2023, with stroke events identified through the Swedish National Patient Register. The authors said the results may not apply in the same way to people in other countries.
Why Scores in the 60s Matter
The findings suggest that cognitive test results in a person’s 60s could help researchers identify a group with higher observed stroke risk. That possibility matters because vascular risk factors and brain health can be addressed before a stroke occurs, although the study did not test whether screening people based on cognitive scores reduces strokes.
Elisabeth Breese Marsh, a neurologist at Johns Hopkins University who was not involved in the study, said its results support attention to vascular risk factors and brain health in midlife. She also said people in their 40s and 50s should focus on habits that support overall brain health. Those comments are expert interpretation; the research itself measured associations and did not evaluate a prevention program.
The age difference also cautions against treating cognitive scores as a uniform marker of stroke risk across older adults. The reported relationship was specific to participants ages 60–69 after adjustment, and the authors said age groups may differ in health conditions, medication use and other factors.
How Swedish Researchers Tracked Stroke
Lead author Alice Askemyr, a geriatrics researcher at Lund University and Skåne University Hospital, said the team examined separate age spans because older adults vary widely. She noted that people in their 80s may have more medical conditions and take more medications than people in their 60s, and that a risk factor at one age may not have the same role later.
Askemyr also proposed that lower cognitive performance among some younger participants could reflect an undetected brain injury that might also be related to later stroke. She cited silent brain injuries as one possible explanation, but the study did not establish that participants with lower scores had such injuries or that these injuries explained the association.
The paper, by Askemyr and colleagues, is titled “Lower Cognitive Function in People Aged 60 to 69 Years Is Associated With Future Stroke.” It was published in 2026 in the American Heart Association’s open-access, peer-reviewed journal. Its Swedish cohort and observational design are central to how its results should be interpreted.
““We chose to investigate different age spans because the older population is very diverse.””
— Alice Askemyr, lead study author
Cause and Screening Remain Unproven
Because the study was observational, it cannot determine whether lower cognitive performance contributes to stroke risk, results from an underlying condition that also raises risk, or reflects other factors. The researchers adjusted for health and lifestyle factors, but that does not prove that all possible explanations were accounted for.
The study also does not establish whether cognitive testing would improve stroke prediction beyond existing assessments or whether screening people with lower scores would change outcomes. Askemyr said the results may not generalize to other countries because healthcare, socioeconomic conditions and lifestyle habits differ. The findings describe one Swedish cohort, not a confirmed causal relationship or a proven screening approach.
Further Research Across Age Groups
The study reports follow-up through the available Swedish records, but the supplied report does not specify a next research milestone or a planned follow-up study. Further research would need to test whether the age-specific association appears in other populations and whether cognitive scores add useful information to established stroke-risk assessments.
For now, the authors’ results support continued study of cognition and vascular health together. Marsh’s prevention comments reflect her expert advice, while decisions about personal stroke risk and screening should be based on an individual’s circumstances and discussion with a qualified health professional.
Key Questions
What did the Swedish study find?
Among adults ages 60–69, lower scores in overall thinking ability, memory and processing speed were associated with higher risk of a first stroke during follow-up. The study did not find the same pattern among participants ages 70 and older after adjustment for health and lifestyle factors.
How many people took part?
The study included 4,912 adults ages 60 and older. Over an average 12.3 years, 572 had a first stroke.
Does the study show that lower cognitive scores cause strokes?
No. It was an observational study, so it found an association but cannot establish cause and effect.
Could cognitive testing identify people at higher stroke risk?
The findings suggest cognitive scores could be studied as a potential risk marker, particularly for people in their 60s. The research did not show that screening improves prediction or prevents strokes.
Source: rss
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