JAMA Netw Open

Higher education tied to faster cognitive decline post-stroke

April 2, 2025

Study details: In this meta-analysis, researchers analyzed cognitive outcomes in 2,019 stroke survivors from 1971 to 2019, categorized by education level: less than high school, high school, some college, and college graduates. Cognitive assessments included global cognition, executive function, and memory.

Results: College graduates initially performed better in global cognition post-stroke (1.09 points higher; 95% confidence interval [CI] 0.02 - 2.17), but experienced faster declines in executive functioning (-0.44 points/year faster; 95% CI, -0.69 to -0.18) over time than those with some college education (-0.30 points/year faster; 95% CI, -0.57 to -0.03). Education level wasn’t associated with declines in global cognition or memory.

Clinical impact: Higher education may provide initial cognitive resilience post-stroke, but once a critical threshold of brain injury is reached, rapid cognitive decline occurs. Identifying high-risk patients can help target interventions to slow cognitive decline and improve post-stroke care.

Source:

Springer MV, et al. (2025, March 3). JAMA Netw Open. Education Levels and Poststroke Cognitive Trajectories. https://pubmed.ncbi.nlm.nih.gov/40136300/