Associations Between Atherosclerotic Cardiovascular Disease (ASCVD) Risk Factors and Post-stroke Cognitive Decline
Thomas Hosseini1, Chinenye Ibekwe3, Dace Almane3, Beril Mat3, Anna Przybelski3, Jenn Cava3, Joseph Rufflo3, Troy Showers3, Shauna Chladek3, Timothy Choi3, Ciara Harkin3, Anusha Adluru3, Nicole Foytik4, Jana Jones3, Bruce Hermann3, Vivek Prabhakaran1, Nagesh Adluru2, Veena Nair1
1Department of Radiology, University of Wisconsin-Madison, 2Waisman Center, University of Wisconsin-Madison, 3University of Wisconsin-Madison, 4UnityPoint Health - Meriter
Objective:
We sought to determine whether atherosclerotic cardiovascular disease (ASCVD) risk factors assessed post-stroke are associated with post-stroke cognitive decline.
Background:
Eleven ASCVD risk factors, which include high blood pressure and low-density lipoprotein (LDL) cholesterol levels, have been associated with cognitive impairment in stroke-free adults. It is unclear whether such risk factors are associated with similar cognitive implications in individuals who have suffered an ischemic stroke. Post-stroke levels of these risk factors could accelerate future cognitive impairments. Design/Methods:
Ischemic stroke patients (n = 31, 10 female, 21 male, mean age = 66.0 years ± 11.0 years, mean days since stroke = 57.7 days ± 28.9 days, 51.6% MCA territory) were administered the MarkVCID neuropsychological battery assessing language, visual perception, memory, and executive function. Raw scores were converted to age, sex, and education adjusted Z scores. ASCVD risk was quantified as a percentage using the American College of Cardiology’s ASCVD Risk Estimator Plus. Pearson r correlations examined the associations between ASCVD scores and cognitive function. Correlations with p ≤ 0.05 were reported.
Results:
There is a strong negative association between ASCVD scores (mean score = 22.8% ± 15.4%, high risk (≥ 20%) n = 15) and Z scores in all four domains: language (category fluency) (r = -0.36), visual perception (facial recognition) (r = -0.41), memory (Craft Story 21 delayed verbal recall) (r = -0.45), and executive function (Symbol Digit Modalities Test) (r = -0.49).
Conclusions:
These findings suggest that higher vascular burden as defined by the ASCVD Risk Estimator is correlated with lower cognitive performance in ischemic stroke survivors.