Changes in memory before and after stroke differ by age and sex, but not by race

Qianyi Wang, Iván Mejía-Guevara, Pamela M. Rist, Stefan Walter, Benjamin D. Capistrant, M. Maria Glymour

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Background: Post-stroke memory impairment is more common among older adults, women and blacks. It is unclear whether post-stroke differences reflect differential effects of stroke per se or differences in prestroke functioning. We compare memory trajectories before and after stroke by age, sex and race. Methods: Health and Retirement Study participants aged ≥50 years (n = 17,341), with no stroke history at baseline, were interviewed biennially up to 10 years for first self- or proxy-reported stroke (n = 1,574). Segmented linear regression models were used to compare annual rates of memory change before and after stroke among 1,169 stroke survivors, 405 stroke decedents and 15,767 stroke-free participants. Effect modification was evaluated with analyses stratified by baseline age (≤70 vs. >70), sex and race (white vs. nonwhite), and using interaction terms between age/sex/race indicators and annual memory change. Results: Older (>70 years) adults experienced a faster memory decline before stroke (-0.19 vs. -0.10 points/year for survivors, -0.24 vs. -0.13 points/year for decedents, p < 0.001 for both interactions), and among stroke survivors, larger memory decrements (-0.64 vs. -0.26 points, p < 0.001) at stroke and faster memory decline (-0.15 vs. -0.07 points/year, p = 0.003) after stroke onset, compared to younger adults. Female stroke survivors experienced a faster prestroke memory decline than male stroke survivors (-0.14 vs. -0.10 points/year, p < 0.001). However, no sex differences were seen for other contrasts. Although whites had higher post-stroke memory scores than nonwhites, race was not associated with rate of memory decline during any period of time; i.e. race did not significantly modify the rate of decline before or after stroke or the immediate effect of stroke on memory. Conclusions: Older age predicted worse memory change before, at and after stroke onset. Sex and race differences in post-stroke memory outcomes might be attributable to prestroke disparities, which may be unrelated to cerebrovascular disease.

Original languageEnglish (US)
Pages (from-to)235-243
Number of pages9
JournalCerebrovascular Diseases
Volume37
Issue number4
DOIs
StatePublished - Jun 2014

Keywords

  • Effect modifier
  • Memory change
  • Stroke

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    Wang, Q., Mejía-Guevara, I., Rist, P. M., Walter, S., Capistrant, B. D., & Glymour, M. M. (2014). Changes in memory before and after stroke differ by age and sex, but not by race. Cerebrovascular Diseases, 37(4), 235-243. https://doi.org/10.1159/000357557