Framingham Stroke Risk Profile and poor cognitive function: a population-based study

David J Llewellyn¹ , Iain A Lang² , Jing Xie¹ , Felicia A Huppert³ , David Melzer² and Kenneth M Langa⁴^,5^,6

¹Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK

²Public Health and Epidemiology Group, Peninsula Medical School, Exeter, UK

³Department of Psychiatry, University of Cambridge, Cambridge, UK

⁴Department of Internal Medicine, University of Michigan, Michigan, USA

⁵Veterans Affairs Center for Practice Management and Outcomes Research, Michigan, USA

⁶Institute for Social Research, University of Michigan, Michigan, USA

author email corresponding author email

BMC Neurology 2008, 8:12doi:10.1186/1471-2377-8-12


Published:	22 April 2008

Abstract

Background

The relationship between stroke risk and cognitive function has not previously been examined in a large community living sample other than the Framingham cohort. The objective of this study was to examine the relationship between 10-year risk for incident stroke and cognitive function in a large population-based sample.

Methods

Participants were 7377 adults aged 50 years and over of the 2002 wave of the English Longitudinal Study of Ageing, a prospective cohort study. A modified version of the Framingham Stroke Risk Profile (incorporating age, sex, systolic blood pressure, antihypertensive medication, diabetes, smoking status, cardiovascular disease, and atrial fibrillation) was used to assess 10-year risk of stroke. Linear regression models were used to determine the cross-sectional relationship of stroke risk to global cognitive function and performance in multiple cognitive domains.

Results

In unadjusted models 10 percentage point increments of 10-year stroke risk were associated with poor global cognitive function (-0.40 SD units, 95% CI -0.43 – -0.38), and lowered performance in all cognitive domains. After statistical adjustment for age, sex, testing interval and other correlates of cognitive function the association with stroke risk was attenuated though remained significant for global cognitive function (-0.06 SD units, 95% CI -0.09 – -0.03), immediate and delayed verbal memory, semantic verbal fluency and processing speed.

Conclusion

In individuals free from a history of stroke or dementia, high subclinical cerebrovascular disease burden was associated with worse cognitive function in multiple domains.