Adults in their 60s who perform poorly on tests of overall thinking ability, memory, and information-processing speed face a substantially higher risk of experiencing a stroke later in life, according to new research conducted in Sweden and published in the Journal of the American Heart Association, an open-access, peer-reviewed journal of the American Heart Association.
The study, which followed nearly 5,000 older adults ages 60 to 80+ for an average of 12 years, found that among participants in their 60s, lower overall thinking ability was linked to an 86% higher risk of stroke, lower memory scores to a 68% higher risk, and lower information-processing speed to a 66% higher risk. During the follow-up period, more than 10% of participants had a first-time stroke. All participants had no history of dementia, stroke, or transient ischemic attack at enrollment.
Notably, the same cognitive-stroke risk pattern was not observed among adults ages 70-79 or 80 and older after researchers accounted for other health and lifestyle factors. Lead study author Alice Askemyr, M.D., a geriatrics researcher at Lund University and Skane University Hospital in Malmo, Sweden, explained that the older population is very diverse. "While many people in their 60s may have only a few medical conditions, people in their 80s often suffer from multiple medical conditions and take numerous medications," she said. "Furthermore, what serves as a risk factor in early life might not serve as one if it is acquired later in life and vice versa."
Askemyr suggested that poor cognitive performance among the younger participants could indicate undetected brain injury. "So-called 'silent' brain injuries can affect both cognitive functioning and the future risk of stroke," she said. "They affect roughly 70% of adults over age 70, so their effects may be easier to detect among people in their 60s, when such injuries and other factors that can affect cognition, including medical conditions and medications, are less common."
The implications of these findings are significant for early stroke prevention. Elisabeth Breese Marsh, M.D., FAHA, chair of the 2026 American Heart Association Scientific Statement, Brain Health Across the Life Span: A Framework for Future Studies, who was not involved in the study, emphasized that even people in their 40s and 50s need to focus on risk factor modification and habits for good overall brain health. "This study, in conjunction with others, supports how important it is to be aggressive in managing vascular risk factors and focusing on brain health in midlife, before many people typically begin to think about it," said Marsh, a professor of neurology and director of the Bayview Stroke Center at The Johns Hopkins University School of Medicine in Baltimore. "This would improve both cognitive performance and stroke risk in older age." She added that because it is unclear whether cognitive impairment itself increases stroke risk, the study provides a new potential screening factor to identify those at higher risk.
The American Stroke Association, a division of the American Heart Association, notes that overall health, lifestyle and environment can affect brain health and cognition over time. The study included 4,912 adults from the Good Aging in Skane project, with data collected from 2001 to 2023. Cognitive function was assessed using standardized tests, and scores were grouped into low, middle, and high performance. The study was observational, meaning it found a link but cannot prove cause and effect, and findings may not be generalizable to other countries due to differences in healthcare, socioeconomics, and lifestyle habits.
For more information on stroke risk factors, visit the American Stroke Association's Stroke Risk Factors page. Additional resources include the American Heart Association news release Brain health shaped by lifetime mental, physical, environmental and lifestyle factors and Older adults’ driving habits offer window into brain health, cognitive decline. The manuscript will be available online after Sept. 30, 2026, at manuscript, and the original release can be viewed at www.newmediawire.com.
