Older adults with cognitive impairment have a greatly elevated risk of experiencing a stroke, according to newly published research findings.

Seniors who scored lower on cognitive tests administered every three years had a 61% higher chance of having stroke, the investigators determined. Cognitive decline increased stroke risk five-fold in African Americans compared to European Americans. After stroke, cognition began to decline about twice as fast in both groups, and the risk of death increased.

This study differed from most previous work because it looked at cognitive declines prior to stroke rather than after, stated lead author Kumar Rajan, Ph.D., of Chicago’s Rush University Medical Center.

The finding has implications for care, as providers might be able to lower stroke risk by addressing cognitive decline. Physical and mental exercises have been shown to slow this decline, the investigators noted.

The study involved about 7,200 adults age 64 or older, who were given four cognitive tests every three years. About 15% of the participants experienced a stroke. Complete findings were published Thursday online and are forthcoming in the American Heart Association’s journal Stroke.