Longitudinal Associations of Stroke With Cognitive Impairment Among Older Adults in the United States: A Population-Based Study
Objective: The aim of this study was to explore the longitudinal associations of stroke with cognitive impairment in older US adults.Method: The data used in this longitudinal analysis were extracted from the National Health and Aging Trends Study (NHATS) from 2011 to 2019. Univariate and multivaria...
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Frontiers Media S.A.
2021-05-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2021.637042/full |
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| author | Xia Wu Li Fan Songqing Ke Yangting He Ke Zhang Shijun Yang |
| author_facet | Xia Wu Li Fan Songqing Ke Yangting He Ke Zhang Shijun Yang |
| author_sort | Xia Wu |
| collection | DOAJ |
| description | Objective: The aim of this study was to explore the longitudinal associations of stroke with cognitive impairment in older US adults.Method: The data used in this longitudinal analysis were extracted from the National Health and Aging Trends Study (NHATS) from 2011 to 2019. Univariate and multivariable Cox proportional hazards regression models were used to estimate the longitudinal association of stroke with cognitive impairment. The multivariable model was adjusted by demographic, physical, and mental characteristics, and the complex survey design of NHATS was taken into consideration.Results: A total of 7,052 participants with complete data were included. At the baseline, the weighted proportion of cognitive impairment was 19.37% (95% CI, 17.92–20.81%), and the weighted proportion of the history of stroke was 9.81% (95% CI, 8.90–10.72%). In univariate analysis, baseline stroke history was significantly associated with cognitive impairment in the future (hazard ratio, 1.746; 95% CI, 1.461–2.088), and the baseline cognitive impairment was significantly associated with future report of stroke (hazard ratio, 1.436; 95% CI, 1.088–1.896). In multivariable model, stroke was also significantly associated with cognitive impairment (hazard ratio, 1.241; 95% CI, 1.011–1.522); however, the reverse association was not significant (hazard ratio, 1.068; 95% CI, 0.788–1.447). After the data from proxy respondents were excluded, in the sensitive analyses, the results remained unchanged.Conclusion: Older adults in the United States who suffered strokes are more likely to develop cognitive impairment as a result in the future than those who have not had strokes. However, the reverse association did not hold. Furthermore, the study suggests that it is necessary to screen and take early intervention for cognitive impairment in stroke survivors and prevent the incidence of stroke by modifying risk factors in the general population with rapidly growing older US adults. |
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| language | English |
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| publishDate | 2021-05-01 |
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| series | Frontiers in Public Health |
| spelling | doaj.art-cd5eabb7a86b47699ae1edb3b34cb3d12022-12-21T21:46:48ZengFrontiers Media S.A.Frontiers in Public Health2296-25652021-05-01910.3389/fpubh.2021.637042637042Longitudinal Associations of Stroke With Cognitive Impairment Among Older Adults in the United States: A Population-Based StudyXia Wu0Li Fan1Songqing Ke2Yangting He3Ke Zhang4Shijun Yang5Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaMinistry of Education Key Laboratory of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaMinistry of Education Key Laboratory of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaBiostatistician at Causality Clinical Data Technology Co., Ltd, Wuhan, ChinaDepartment of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaObjective: The aim of this study was to explore the longitudinal associations of stroke with cognitive impairment in older US adults.Method: The data used in this longitudinal analysis were extracted from the National Health and Aging Trends Study (NHATS) from 2011 to 2019. Univariate and multivariable Cox proportional hazards regression models were used to estimate the longitudinal association of stroke with cognitive impairment. The multivariable model was adjusted by demographic, physical, and mental characteristics, and the complex survey design of NHATS was taken into consideration.Results: A total of 7,052 participants with complete data were included. At the baseline, the weighted proportion of cognitive impairment was 19.37% (95% CI, 17.92–20.81%), and the weighted proportion of the history of stroke was 9.81% (95% CI, 8.90–10.72%). In univariate analysis, baseline stroke history was significantly associated with cognitive impairment in the future (hazard ratio, 1.746; 95% CI, 1.461–2.088), and the baseline cognitive impairment was significantly associated with future report of stroke (hazard ratio, 1.436; 95% CI, 1.088–1.896). In multivariable model, stroke was also significantly associated with cognitive impairment (hazard ratio, 1.241; 95% CI, 1.011–1.522); however, the reverse association was not significant (hazard ratio, 1.068; 95% CI, 0.788–1.447). After the data from proxy respondents were excluded, in the sensitive analyses, the results remained unchanged.Conclusion: Older adults in the United States who suffered strokes are more likely to develop cognitive impairment as a result in the future than those who have not had strokes. However, the reverse association did not hold. Furthermore, the study suggests that it is necessary to screen and take early intervention for cognitive impairment in stroke survivors and prevent the incidence of stroke by modifying risk factors in the general population with rapidly growing older US adults.https://www.frontiersin.org/articles/10.3389/fpubh.2021.637042/fullstrokecognitive declineolderlongitudinal analysisUnited States |
| spellingShingle | Xia Wu Li Fan Songqing Ke Yangting He Ke Zhang Shijun Yang Longitudinal Associations of Stroke With Cognitive Impairment Among Older Adults in the United States: A Population-Based Study Frontiers in Public Health stroke cognitive decline older longitudinal analysis United States |
| title | Longitudinal Associations of Stroke With Cognitive Impairment Among Older Adults in the United States: A Population-Based Study |
| title_full | Longitudinal Associations of Stroke With Cognitive Impairment Among Older Adults in the United States: A Population-Based Study |
| title_fullStr | Longitudinal Associations of Stroke With Cognitive Impairment Among Older Adults in the United States: A Population-Based Study |
| title_full_unstemmed | Longitudinal Associations of Stroke With Cognitive Impairment Among Older Adults in the United States: A Population-Based Study |
| title_short | Longitudinal Associations of Stroke With Cognitive Impairment Among Older Adults in the United States: A Population-Based Study |
| title_sort | longitudinal associations of stroke with cognitive impairment among older adults in the united states a population based study |
| topic | stroke cognitive decline older longitudinal analysis United States |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2021.637042/full |
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