Cognitive function in adolescence and the risk of early-onset stroke

BackgroundStroke is increasingly prevalent at younger ages but the risk factors are uncertain. We examined the association between adolescent cognitive function and early-onset stroke.MethodsThis was a nationwide population-based cohort study of 1 741 345 Israeli adolescents (42% women) who underwen...

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Published in:Journal of epidemiology and community health (1979) 2024-09, Vol.78 (9), p.570-577
Main Authors: Bardugo, Aya, Bendor, Cole D, Libruder, Carmit, Lutski, Miri, Zucker, Inbar, Tsur, Avishai M, Derazne, Estela, Yaniv, Gal, Gardner, Raquel C, Gerstein, Hertzel C, Cukierman-Yaffe, Tali, Lebenthal, Yael, Batty, David, Tanne, David, Furer, Ariel, Afek, Arnon, Twig, Gilad
Format: Article
Language:English
Subjects:
Adolescence
Adolescent
Adolescents
Adult
Age
Age of Onset
Blood pressure
Body mass index
Cardiovascular disease
Child development
Chronic illnesses
Cognition
Cognitive ability
Cohort Studies
Dementia
Diabetes
Diabetes mellitus
Female
Health risks
Hemorrhage
Humans
Hypertension
Intelligence
Ischemia
Ischemic Stroke - epidemiology
Israel - epidemiology
Male
Middle Aged
Original research
Population studies
Registries
Risk Factors
Sensitivity analysis
Socioeconomic factors
Stroke
Stroke - epidemiology
Teenagers
Young Adult
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Summary:BackgroundStroke is increasingly prevalent at younger ages but the risk factors are uncertain. We examined the association between adolescent cognitive function and early-onset stroke.MethodsThis was a nationwide population-based cohort study of 1 741 345 Israeli adolescents (42% women) who underwent comprehensive cognitive function tests at age 16–20 years, before mandatory military service, during 1987–2012. Cognitive function (range: 1–9) was categorised as low (1–3, corresponding to IQ score below 89), medium (4–7, IQ score range: 89–118), or high (8–9, IQ score above 118). Participant data were linked to the Israeli National Stroke Registry. Cox proportional hazard models were used to estimate risks for the first occurrence of ischaemic stroke during 2014–2018.ResultsDuring 8 689 329 person-years of follow-up, up to a maximum age of 50 years, 908 first stroke events occurred (767 ischaemic and 141 haemorrhagic). Compared with a reference group of people with high cognitive function, body mass index-adjusted and sociodemographic-adjusted HRs (95% CIs) for early-onset stroke were 1.78 (1.33–2.38) in medium and 2.68 (1.96–3.67) in low cognitive function groups. There was evidence of a dose–response relationship (P for trend
ISSN:0143-005X
1470-2738
1470-2738
DOI:10.1136/jech-2024-222114