Cognitive Impairment Risk Following Stroke Varies Among Certain Ethnic Groups

Stroke associated with cognitive impairment occurs at similar rates across ethnicities; however, non-Hispanic White patients experience greater associations between cognitive impairment and stroke than Mexican American patients, according to study findings published in Stroke.

Researchers conducted a population-based cohort study in a biethnic community in Nueces County, Texas from May 2018 to December 2021. They analyzed the differences between cognitive impairment among Mexican Americans after stroke compared with non-Hispanic White Americans.

The researchers enrolled 1801 participants (55% female; 50% Mexican American, 44% Non-Hispanic White, 6% other ethnicities). Of these 1801 people, 12.4% reported a history of stroke. Stroke occurred with similar incidence across all ethnicities (P =.34).

Participants with a history of stroke completed the Montreal Cognitive Assessment (MoCA). The researchers divided MoCA scores into 3 categories corresponding to normal cognition (scores from 26 to 30), mild cognitive impairment (scores from 20 to 25), and probable dementia (scores from 0 to 19).

Stroke positively correlated with cognitive impairment across ethnicities; however, non-Hispanic White patients demonstrated a greater magnitude of association between cognitive impairments and stroke compared with Mexican American patients (cumulative odds ratio [OR]: 1.58; 95% CI, 1.04-2.41).

In contrast, Mexican American participants demonstrated a higher prevalence of cognitive impairments, especially probable dementia, compared with other underrepresented ethnic groups.

Regardless of ethnic background, older age and lower educational status independently correlated with cognitive impairment. However, hypertension did not correlate with increased dementia risk in this study.

“History of stroke was associated with increased odds of cognitive impairment…in both MA [Mexican Americans] and NHW [non-Hispanic White] participants,” the researchers stated. “The magnitude of the impact of stroke on cognition was less in MA than in Non-Hispanic White participants.”

“Overall, our findings underscore the importance of aggressive stroke prevention measures not only to minimize the morbidity of poststroke cognitive impairment for patients and caregivers, but also to reduce the burden of dementia at a population level,” they concluded.

Study limitations include reliance on self-reported medical information (which increased potential for recall bias), used of the MoCA instead of clinical and neuropsychological evaluations to measure cognitive impairment, and the inability to assess stroke severity, recurrence of strokes, and type of stroke (ischemic or hemorrhagic).

Disclosures: Study authors declared affiliations with NIH, Northwestern University, and the Alzheimers Association. Please see the original reference for a full list of authors’ disclosures.